How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $7,244Professionalmedian $3,467 · 10th to 90th $2,042 to $5,129
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 $2,454.71 | Professional | None | $2,089.30 | $2,089.30 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,715.35 | $5,623.41 |
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 $2,041.74 Median $2,630.27 Typical High $5,623.41 | Professional | None | $2,041.74 | $2,630.27 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $6,918.31 | Facility | None | $2,089.30 | $2,511.89 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,187.76 | $2,398.83 | $3,388.44 |
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 $1,949.84 Median $2,691.53 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,691.53 | $5,128.61 |
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 $416.87 Median $416.87 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $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 $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,174.90 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $1,096.48 | $1,174.90 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $478.63 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $436.52 | $478.63 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $331.13 Typical High $831.76 | Professional | 81 · Minimal assistant surgeon | $302.00 | $331.13 | $831.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $331.13 Typical High $831.76 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $331.13 | $831.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $331.13 Typical High $831.76 | Professional | AS · PA/NP assist | $302.00 | $331.13 | $831.76 |
Where North Carolina sits
The same service costs 8.1 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· 14th of 51
$3,388
AK $8,913TX $1,096
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.