How much rates vary
Facilitymedian $851 · 10th to 90th $398 to $7,586Professionalmedian $575 · 10th to 90th $417 to $1,023
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $416.87 Median $1,148.15 Typical High $7,943.28 | Facility | None | $416.87 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,047.13 | Professional | None | $512.86 | $741.31 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $29,512.09 | Facility | None | $478.63 | $794.33 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $831.76 | Professional | None | $446.68 | $537.03 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $1,513.56 | Facility | None | $416.87 | $501.19 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Professional | None | $446.68 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $1,023.29 | Professional | None | $380.19 | $549.54 | $1,023.29 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $245.47 Typical High $588.84 | Professional | 51 · Multiple procedures | $223.87 | $245.47 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $100.00 Typical High $234.42 | Professional | 80 · Assistant surgeon | $89.13 | $100.00 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $69.18 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $61.66 | $69.18 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $69.18 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $69.18 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $69.18 Typical High $162.18 | Professional | AS · PA/NP assist | $61.66 | $69.18 | $162.18 |
Where North Carolina sits
The same service costs 6.0 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 25th of 51
$589
AK $1,380UT $229
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.