How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,311 · 10th to 90th $1,175 to $6,026
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 $2,454.71 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,454.71 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $4,073.80 Typical High $6,606.93 | Professional | None | $1,174.90 | $4,073.80 | $6,606.93 |
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 $2,290.87 Median $3,019.95 Typical High $6,456.54 | Professional | None | $2,290.87 | $3,019.95 | $6,456.54 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $8,128.31 | Facility | None | $2,454.71 | $2,951.21 | $8,128.31 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,630.27 | $4,265.80 |
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 $2,137.96 Median $3,019.95 Typical High $6,025.60 | Professional | None | $2,137.96 | $3,019.95 | $6,025.60 |
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 $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 53 · Discontinued | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,318.26 Typical High $3,548.13 | Professional | 51 · Multiple procedures | $1,258.93 | $1,318.26 | $3,548.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $524.81 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $501.19 | $524.81 | $1,412.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $371.54 Typical High $1,000.00 | Professional | 81 · Minimal assistant surgeon | $346.74 | $371.54 | $1,000.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $371.54 Typical High $1,000.00 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $371.54 | $1,000.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $371.54 Typical High $1,000.00 | Professional | AS · PA/NP assist | $346.74 | $371.54 | $1,000.00 |
Where North Carolina sits
The same service costs 17.4 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· 23rd of 51
$3,162
AK $10,471TX $603
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.