How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $7,244Professionalmedian $692 · 10th to 90th $417 to $1,072
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 $416.87 Typical High $7,943.28 | Facility | None | $416.87 | $416.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | None | $416.87 | $416.87 | $616.60 |
BCBS North Carolina Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,096.48 | Professional | None | $512.86 | $776.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $851.14 | Professional | None | $467.74 | $549.54 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $1,548.82 | Facility | None | $416.87 | $501.19 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $676.08 | Professional | None | $457.09 | $512.86 | $676.08 |
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 $398.11 Median $562.34 Typical High $1,023.29 | Professional | None | $398.11 | $562.34 | $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 $208.93 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $257.04 Typical High $588.84 | Professional | 51 · Multiple procedures | $229.09 | $257.04 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $102.33 Typical High $239.88 | Professional | 80 · Assistant surgeon | $91.20 | $102.33 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $72.44 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $64.57 | $72.44 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $72.44 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $72.44 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $72.44 Typical High $165.96 | Professional | AS · PA/NP assist | $64.57 | $72.44 | $165.96 |
Where North Carolina sits
The same service costs 5.0 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· 12th of 51
$692
AK $1,349UT $269
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.