How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,818 · 10th to 90th $1,549 to $3,715
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 $1,513.56 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,513.56 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,041.74 | $3,235.94 | $4,168.69 |
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 $1,584.89 Median $1,995.26 Typical High $4,073.80 | Professional | None | $1,584.89 | $1,995.26 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $5,370.32 | Facility | None | $1,513.56 | $1,819.70 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,862.09 | $2,511.89 |
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 $1,479.11 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,479.11 | $2,041.74 | $3,715.35 |
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 $758.58 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $933.25 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $724.44 | $933.25 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $371.54 Typical High $870.96 | Professional | 80 · Assistant surgeon | $288.40 | $371.54 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $263.03 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $204.17 | $263.03 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $263.03 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $263.03 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $263.03 Typical High $602.56 | Professional | AS · PA/NP assist | $204.17 | $263.03 | $602.56 |
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· 11th of 51
$2,754
AK $6,457TX $891
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.