How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,630 · 10th to 90th $1,380 to $3,467
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 $1,380.38 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,380.38 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,380.38 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $3,467.37 | Professional | None | $1,819.70 | $3,090.30 | $3,467.37 |
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 $1,412.54 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,412.54 | $1,479.11 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,238.72 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $4,570.88 | Facility | None | $1,380.38 | $1,659.59 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,698.24 | $2,290.87 |
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 $1,174.90 Median $1,621.81 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,621.81 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $851.14 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $707.95 | $851.14 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $676.08 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $234.42 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $199.53 | $234.42 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $234.42 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $234.42 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $467.74 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $467.74 |
Where North Carolina sits
The same service costs 5.9 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· 10th of 51
$2,630
AK $5,888TX $1,000
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.