How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $7,244Professionalmedian $2,344 · 10th to 90th $1,622 to $4,266
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 $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,584.89 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $3,090.30 Typical High $4,365.16 | Professional | None | $1,621.81 | $3,090.30 | $4,365.16 |
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 $1,819.70 Median $2,137.96 Typical High $4,365.16 | Professional | None | $1,819.70 | $2,137.96 | $4,365.16 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $5,495.41 | Facility | None | $1,584.89 | $1,905.46 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,089.30 | $2,630.27 |
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 $1,584.89 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,584.89 | $2,187.76 | $3,981.07 |
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 $794.33 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,047.13 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $870.96 | $1,047.13 | $2,290.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $912.01 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $295.12 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $245.47 | $295.12 | $645.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $295.12 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $295.12 | $645.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $645.65 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $645.65 |
Where North Carolina sits
The same service costs 7.8 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· 18th of 51
$2,291
AK $6,607TX $851
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.