How much rates vary
Facilitymedian $1,380 · 10th to 90th $389 to $8,318Professionalmedian $2,291 · 10th to 90th $1,585 to $4,074
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 $1,659.59 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,659.59 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $4,168.69 | Professional | None | $1,584.89 | $2,818.38 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,630.27 Typical High $29,512.09 | Facility | None | $489.78 | $2,630.27 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,621.81 | $1,737.80 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,981.07 | Professional | None | $2,570.40 | $2,570.40 | $3,981.07 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $5,754.40 | Facility | None | $1,659.59 | $1,995.26 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,778.28 | $2,041.74 | $2,691.53 |
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 $1,412.54 Median $1,905.46 Typical High $4,073.80 | Professional | None | $1,412.54 | $1,905.46 | $4,073.80 |
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 $831.76 Median $831.76 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,023.29 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $891.25 | $1,023.29 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $407.38 Typical High $794.33 | Professional | 80 · Assistant surgeon | $354.81 | $407.38 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $288.40 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $251.19 | $288.40 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $288.40 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $288.40 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $288.40 Typical High $562.34 | Professional | AS · PA/NP assist | $251.19 | $288.40 | $562.34 |
Where North Carolina sits
The same service costs 6.0 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· 20th of 51
$2,291
AK $7,079TX $1,175
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.