How much rates vary
Facilitymedian $1,023 · 10th to 90th $479 to $6,761Professionalmedian $1,950 · 10th to 90th $1,202 to $2,951
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,202.26 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,187.76 | $3,235.94 |
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 $1,148.15 Median $1,548.82 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,548.82 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $4,168.69 | Facility | None | $1,202.26 | $1,412.54 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,445.44 | $2,041.74 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,584.89 | $2,951.21 |
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 $588.84 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $724.44 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $616.60 | $724.44 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $676.08 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $204.17 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $173.78 | $204.17 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $204.17 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $204.17 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $478.63 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $478.63 |
Where North Carolina sits
The same service costs 5.6 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· 15th of 51
$1,950
AK $5,012TX $891
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.