How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,349 · 10th to 90th $955 to $2,512
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 $1,047.13 Median $1,047.13 Typical High $7,943.28 | Facility | None | $1,047.13 | $1,047.13 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $2,630.27 | Professional | None | $954.99 | $1,513.56 | $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 $912.01 Median $977.24 Typical High $2,630.27 | Professional | None | $912.01 | $977.24 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,348.96 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $3,162.28 | Facility | None | $1,047.13 | $1,258.93 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,548.82 | Professional | None | $977.24 | $1,000.00 | $1,548.82 |
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 $831.76 Median $1,096.48 Typical High $2,398.83 | Professional | None | $831.76 | $1,096.48 | $2,398.83 |
12 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 $524.81 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,513.56 Typical High $3,801.89 | Professional | 50 · Both sides | $1,479.11 | $1,513.56 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $501.19 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $489.78 | $501.19 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $199.53 Typical High $512.86 | Professional | 80 · Assistant surgeon | $194.98 | $199.53 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $141.25 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $138.04 | $141.25 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $141.25 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $141.25 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $141.25 Typical High $354.81 | Professional | AS · PA/NP assist | $138.04 | $141.25 | $354.81 |
Where North Carolina sits
The same service costs 21.9 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· 25th of 51
$1,318
AK $4,467TX $204
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.