How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $4,571 · 10th to 90th $2,754 to $7,413
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 $2,691.53 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,691.53 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,691.53 | $2,691.53 | $3,235.94 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $7,943.28 | Professional | None | $3,467.37 | $5,011.87 | $7,943.28 |
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 $2,754.23 Median $2,951.21 Typical High $5,370.32 | Professional | None | $2,754.23 | $2,951.21 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $6,606.93 | Professional | None | $3,890.45 | $3,890.45 | $6,606.93 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,630.78 | Facility | None | $724.44 | $724.44 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,754.23 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,398.83 | $2,398.83 | $2,511.89 |
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 $2,344.23 Median $2,951.21 Typical High $5,128.61 | Professional | None | $2,344.23 | $2,951.21 | $5,128.61 |
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 $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | 53 · Discontinued | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,348.96 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $1,258.93 | $1,348.96 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $549.54 Typical High $691.83 | Professional | 80 · Assistant surgeon | $501.19 | $549.54 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $389.05 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $346.74 | $389.05 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $389.05 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $389.05 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $389.05 Typical High $489.78 | Professional | AS · PA/NP assist | $346.74 | $389.05 | $489.78 |
Where North Carolina sits
The same service costs 22.9 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· 12th of 51
$4,467
AK $9,120TX $398
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.