How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,236 · 10th to 90th $2,239 to $5,370
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 $2,187.76 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,187.76 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,511.89 | Professional | None | $2,187.76 | $2,187.76 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,884.03 Median $3,890.45 Typical High $6,025.60 | Professional | None | $2,884.03 | $3,890.45 | $6,025.60 |
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 $2,344.23 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,344.23 | $2,884.03 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,715.35 | Facility | None | $2,187.76 | $2,630.27 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,019.95 | $3,548.13 |
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 $2,089.30 Median $2,951.21 Typical High $5,370.32 | Professional | None | $2,089.30 | $2,951.21 | $5,370.32 |
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 $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 53 · Discontinued | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,778.28 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $1,348.96 | $1,778.28 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $707.95 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $537.03 | $707.95 | $1,258.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $489.78 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $380.19 | $489.78 | $870.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $489.78 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $489.78 | $870.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $489.78 Typical High $870.96 | Professional | AS · PA/NP assist | $380.19 | $489.78 | $870.96 |
Where North Carolina sits
The same service costs 14.5 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· 19th of 51
$3,162
AK $9,120TX $631
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.