How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $7,762Professionalmedian $4,571 · 10th to 90th $2,399 to $5,888
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 $2,398.83 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,398.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,398.83 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $5,888.44 | Professional | None | $2,951.21 | $5,011.87 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $29,512.09 | Facility | None | $478.63 | $870.96 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $6,025.60 | Professional | None | $2,398.83 | $2,570.40 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Professional | None | $3,630.78 | $3,630.78 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $8,317.64 | Facility | None | $2,398.83 | $2,884.03 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,570.40 | $2,951.21 | $3,981.07 |
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 $2,089.30 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,089.30 | $2,884.03 | $5,888.44 |
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 $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $436.52 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,479.11 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,288.25 | $1,479.11 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $588.84 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $512.86 | $588.84 | $1,148.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $407.38 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $354.81 | $407.38 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $407.38 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $407.38 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $407.38 Typical High $812.83 | Professional | AS · PA/NP assist | $354.81 | $407.38 | $812.83 |
Where North Carolina sits
The same service costs 24.0 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· 11th of 51
$4,365
AK $10,233TX $427
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.