How much rates vary
Facilitymedian $977 · 10th to 90th $380 to $7,244Professionalmedian $1,738 · 10th to 90th $977 to $2,399
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 $977.24 Median $977.24 Typical High $7,943.28 | Facility | None | $977.24 | $977.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,258.93 | $2,089.30 | $2,630.27 |
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 $933.25 Median $1,258.93 Typical High $2,630.27 | Professional | None | $933.25 | $1,258.93 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $3,162.28 | Facility | None | $977.24 | $1,174.90 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,174.90 | $1,621.81 |
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 $933.25 Median $1,288.25 Typical High $2,398.83 | Professional | None | $933.25 | $1,288.25 | $2,398.83 |
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 $489.78 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $794.33 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 58 · Staged procedure | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $588.84 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $501.19 | $588.84 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $549.54 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $165.96 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $141.25 | $165.96 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $165.96 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $165.96 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $389.05 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $389.05 |
Where North Carolina sits
The same service costs 18.6 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· 13th of 51
$1,738
AK $4,169TX $224
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.