How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $19,498Professionalmedian $1,950 · 10th to 90th $1,096 to $3,162
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 $1,584.89 Typical High $11,481.54 | Facility | None | $1,047.13 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,047.13 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,344.23 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $24,547.09 Median $31,622.78 Typical High $32,359.37 | Facility | None | $24,547.09 | $31,622.78 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,548.82 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $4,073.80 | Facility | None | $1,047.13 | $1,258.93 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,778.28 | Professional | None | $831.76 | $1,230.27 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,378.01 | Facility | None | $1,380.38 | $4,265.80 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,479.11 | $2,884.03 |
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 $524.81 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $616.60 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $407.38 | $616.60 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $251.19 Typical High $616.60 | Professional | 80 · Assistant surgeon | $165.96 | $251.19 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $173.78 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $114.82 | $173.78 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $173.78 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $173.78 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $173.78 Typical High $426.58 | Professional | AS · PA/NP assist | $114.82 | $173.78 | $426.58 |
Where North Carolina sits
The same service costs 8.9 times more in Oklahoma 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
$2,089
OK $7,762TX $871
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.