How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,042 · 10th to 90th $1,230 to $3,090
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 $1,230.27 Median $1,230.27 Typical High $7,943.28 | Facility | None | $1,230.27 | $1,230.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,230.27 | $1,230.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,258.93 | $2,137.96 | $3,311.31 |
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,137.96 | Facility | None | $1,230.27 | $1,479.11 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,202.26 | Professional | None | $831.76 | $1,174.90 | $1,202.26 |
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 $977.24 Median $1,258.93 Typical High $2,187.76 | Professional | None | $977.24 | $1,258.93 | $2,187.76 |
9 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 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $575.44 Typical High $575.44 | Professional | 51 · Multiple procedures | $416.87 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 80 · Assistant surgeon | $165.96 | $234.42 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $114.82 | $162.18 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $162.18 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | AS · PA/NP assist | $114.82 | $162.18 | $162.18 |
Where North Carolina sits
The same service costs 16.2 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· 6th of 51
$2,042
AK $3,090TX $191
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.