How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,388 · 10th to 90th $2,138 to $5,248
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 $2,089.30 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,089.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,089.30 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $5,754.40 | Professional | None | $2,818.38 | $3,890.45 | $5,754.40 |
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 $2,238.72 Median $2,818.38 Typical High $5,754.40 | Professional | None | $2,238.72 | $2,818.38 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $8,128.31 | Facility | None | $2,089.30 | $2,511.89 | $8,128.31 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,630.27 | $3,801.89 |
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 $2,041.74 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,041.74 | $2,818.38 | $5,248.07 |
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 $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 53 · Discontinued | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,318.26 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $1,202.26 | $1,318.26 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $524.81 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $478.63 | $524.81 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $363.08 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $338.84 | $363.08 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $363.08 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $363.08 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $363.08 Typical High $851.14 | Professional | AS · PA/NP assist | $338.84 | $363.08 | $851.14 |
Where North Carolina sits
The same service costs 7.2 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· 15th of 51
$3,388
AK $8,913TX $1,230
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.