How much rates vary
Facilitymedian $1,023 · 10th to 90th $513 to $2,455Professionalmedian $912 · 10th to 90th $589 to $1,479
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 $562.34 Median $562.34 Typical High $7,943.28 | Facility | None | $562.34 | $562.34 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,737.80 | Facility | None | $870.96 | $1,288.25 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,584.89 | Professional | None | $588.84 | $1,000.00 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $977.24 Typical High $1,584.89 | Facility | None | $416.87 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,096.48 | Professional | None | $602.56 | $616.60 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,380.38 | Facility | None | $724.44 | $724.44 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $870.96 | Professional | None | $524.81 | $707.95 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,047.13 | Professional | None | $467.74 | $588.84 | $1,047.13 |
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 $275.42 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $354.81 Typical High $446.68 | Professional | 51 · Multiple procedures | $263.03 | $354.81 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $141.25 Typical High $177.83 | Professional | 80 · Assistant surgeon | $107.15 | $141.25 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $100.00 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $74.13 | $100.00 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $100.00 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $100.00 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $100.00 Typical High $125.89 | Professional | AS · PA/NP assist | $74.13 | $100.00 | $125.89 |
Where North Carolina sits
The same service costs 5.5 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· 14th of 51
$912
AK $2,188TX $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.