How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $10,000Professionalmedian $1,549 · 10th to 90th $813 to $1,950
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 $724.44 Median $1,445.44 Typical High $10,715.19 | Facility | None | $724.44 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $2,041.74 | Professional | None | $977.24 | $1,621.81 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,412.54 | Professional | None | $812.83 | $870.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,230.27 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,174.90 Typical High $4,265.80 | Facility | None | $831.76 | $1,174.90 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $912.01 | Professional | None | $676.08 | $724.44 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
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 $363.08 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $602.56 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $645.65 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $645.65 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $398.11 Typical High $478.63 | Professional | 51 · Multiple procedures | $338.84 | $398.11 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $144.54 Typical High $186.21 | Professional | 80 · Assistant surgeon | $134.90 | $144.54 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $95.50 | $102.33 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $102.33 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | AS · PA/NP assist | $95.50 | $102.33 | $128.82 |
Where North Carolina sits
The same service costs 6.2 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· 7th of 51
$1,549
AK $3,020TX $490
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.