How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $6,310Professionalmedian $1,288 · 10th to 90th $813 to $2,089
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 $660.69 Median $851.14 Typical High $8,511.38 | Facility | None | $660.69 | $851.14 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $912.01 | Professional | None | $660.69 | $851.14 | $912.01 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,137.96 | Professional | None | $812.83 | $1,412.54 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,479.11 | Professional | None | $758.58 | $912.01 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,318.26 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,096.48 Typical High $4,265.80 | Facility | None | $724.44 | $1,096.48 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | None | $758.58 | $758.58 | $794.33 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,380.38 | Professional | None | $630.96 | $812.83 | $1,380.38 |
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 $331.13 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $616.60 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | 51 · Multiple procedures | $407.38 | $407.38 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $162.18 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $114.82 | $114.82 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $114.82 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $114.82 | $114.82 | $154.88 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 10th of 51
$1,288
AK $2,754NJ $631
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.