How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,950 · 10th to 90th $1,349 to $3,467
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 $1,288.25 Median $1,412.54 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $3,801.89 | Professional | None | $1,348.96 | $2,570.40 | $3,801.89 |
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 $1,445.44 Median $1,819.70 Typical High $3,801.89 | Professional | None | $1,445.44 | $1,819.70 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $5,128.61 | Facility | None | $1,412.54 | $1,659.59 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,698.24 | $2,290.87 |
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 $1,348.96 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,348.96 | $1,862.09 | $3,467.37 |
12 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 $691.83 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,122.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,570.40 Typical High $6,025.60 | Professional | 50 · Both sides | $2,290.87 | $2,570.40 | $6,025.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $346.74 Typical High $794.33 | Professional | 80 · Assistant surgeon | $309.03 | $346.74 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $239.88 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $213.80 | $239.88 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $239.88 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $239.88 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $239.88 Typical High $562.34 | Professional | AS · PA/NP assist | $213.80 | $239.88 | $562.34 |
Where North Carolina sits
The same service costs 7.8 times more in Alaska than in Texas. 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· 23rd of 51
$1,950
AK $5,888TX $759
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.