How much rates vary
Facilitymedian $1,995 · 10th to 90th $468 to $6,310Professionalmedian $490 · 10th to 90th $324 to $776
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 $281.84 Median $389.05 Typical High $7,762.47 | Facility | None | $281.84 | $389.05 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | None | $281.84 | $281.84 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | None | $223.87 | $223.87 | $275.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,754.23 | Facility | None | $1,318.26 | $1,995.26 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $812.83 | Professional | None | $380.19 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,073.80 Typical High $6,025.60 | Facility | None | $645.65 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $562.34 | Professional | None | $323.59 | $323.59 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $676.08 | Professional | None | $467.74 | $467.74 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $4,570.88 | Facility | None | $537.03 | $977.24 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $512.86 | Professional | None | $275.42 | $398.11 | $512.86 |
Oscar Health Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $9,332.54 | Facility | None | $3,467.37 | $3,467.37 | $9,332.54 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | None | $354.81 | $354.81 | $371.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $8,709.64 | Facility | None | $851.14 | $1,778.28 | $8,709.64 |
United Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $537.03 | Professional | None | $251.19 | $316.23 | $537.03 |
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 $141.25 Median $141.25 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $234.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $549.54 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $295.12 | $549.54 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $218.78 Typical High $281.84 | Professional | 51 · Multiple procedures | $138.04 | $218.78 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $81.28 Typical High $102.33 | Professional | 80 · Assistant surgeon | $54.95 | $81.28 | $102.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $57.54 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $38.90 | $57.54 | $72.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $57.54 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $57.54 | $72.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $57.54 Typical High $72.44 | Professional | AS · PA/NP assist | $38.90 | $57.54 | $72.44 |
Where North Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 13th of 51
$490
AK $1,202UT $219
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.