How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,570 · 10th to 90th $1,862 to $4,467
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 $1,819.70 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,819.70 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $5,011.87 | Professional | None | $1,949.84 | $3,311.31 | $5,011.87 |
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 $1,905.46 Median $2,398.83 Typical High $5,011.87 | Professional | None | $1,905.46 | $2,398.83 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,819.70 | $2,187.76 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,041.74 | $2,187.76 | $3,162.28 |
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 $1,778.28 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,778.28 | $2,454.71 | $4,466.84 |
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 $912.01 Median $912.01 Typical High $1,096.48 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 53 · Discontinued | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,096.48 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $1,023.29 | $1,096.48 | $2,630.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $436.52 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $407.38 | $436.52 | $1,047.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $309.03 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $288.40 | $309.03 | $741.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $309.03 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $309.03 | $741.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $309.03 Typical High $741.31 | Professional | AS · PA/NP assist | $288.40 | $309.03 | $741.31 |
Where North Carolina sits
The same service costs 5.9 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· 22nd of 51
$2,512
AK $7,762TX $1,318
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.