How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,570 · 10th to 90th $1,820 to $4,677
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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,698.24 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $4,677.35 | Professional | None | $2,344.23 | $3,388.44 | $4,677.35 |
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 $1,995.26 Median $2,344.23 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,344.23 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $6,606.93 | Facility | None | $1,698.24 | $2,041.74 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,290.87 | $2,951.21 |
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 $1,737.80 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,344.23 | $4,265.80 |
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 $851.14 Median $851.14 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,348.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,467.37 Typical High $7,413.10 | Professional | 50 · Both sides | $3,090.30 | $3,467.37 | $7,413.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,148.15 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $1,047.13 | $1,148.15 | $2,454.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $457.09 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $416.87 | $457.09 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $323.59 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $288.40 | $323.59 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $323.59 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $323.59 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $323.59 Typical High $691.83 | Professional | AS · PA/NP assist | $288.40 | $323.59 | $691.83 |
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· 15th of 51
$2,512
AK $7,079TX $324
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.