How much rates vary
Facilitymedian $955 · 10th to 90th $380 to $7,244Professionalmedian $1,738 · 10th to 90th $955 to $2,399
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 $954.99 Median $954.99 Typical High $7,943.28 | Facility | None | $954.99 | $954.99 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,288.25 | $2,041.74 | $2,630.27 |
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 $977.24 Median $1,258.93 Typical High $2,570.40 | Professional | None | $977.24 | $1,258.93 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $3,467.37 | Facility | None | $954.99 | $1,148.15 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,174.90 | $1,698.24 |
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 $912.01 Median $1,258.93 Typical High $2,344.23 | Professional | None | $912.01 | $1,258.93 | $2,344.23 |
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 $478.63 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $588.84 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $512.86 | $588.84 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $234.42 Typical High $549.54 | Professional | 80 · Assistant surgeon | $208.93 | $234.42 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $162.18 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $144.54 | $162.18 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $162.18 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $162.18 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $162.18 Typical High $380.19 | Professional | AS · PA/NP assist | $144.54 | $162.18 | $380.19 |
Where North Carolina sits
The same service costs 6.8 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
$1,738
AK $4,074TX $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.