How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,349 to $3,548
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 $1,445.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,445.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,659.59 | $2,344.23 | $3,890.45 |
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 $1,288.25 Median $1,698.24 Typical High $3,548.13 | Professional | None | $1,288.25 | $1,698.24 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $4,677.35 | Facility | None | $1,445.44 | $1,737.80 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,548.82 | $2,344.23 |
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 $1,230.27 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,659.59 | $3,548.13 |
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 $724.44 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $776.25 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $707.95 | $776.25 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $831.76 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $218.78 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $199.53 | $218.78 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $218.78 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $218.78 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $218.78 Typical High $575.44 | Professional | AS · PA/NP assist | $199.53 | $218.78 | $575.44 |
Where North Carolina sits
The same service costs 8.5 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· 16th of 51
$2,239
AK $6,166TX $724
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.