How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,020 · 10th to 90th $1,660 to $4,074
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 $1,621.81 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,621.81 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,137.96 | $3,467.37 | $4,466.84 |
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 $1,737.80 Median $2,187.76 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,187.76 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $5,888.44 | Facility | None | $1,621.81 | $1,949.84 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,995.26 | $2,691.53 |
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 $1,584.89 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,584.89 | $2,187.76 | $4,073.80 |
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 $812.83 Median $812.83 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 53 · Discontinued | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,000.00 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $933.25 | $1,000.00 | $2,344.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $407.38 Typical High $933.25 | Professional | 80 · Assistant surgeon | $371.54 | $407.38 | $933.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $281.84 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $263.03 | $281.84 | $660.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $281.84 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $281.84 | $660.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $281.84 Typical High $660.69 | Professional | AS · PA/NP assist | $263.03 | $281.84 | $660.69 |
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· 11th of 51
$2,951
AK $6,918TX $1,175
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.