How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $4,467 · 10th to 90th $2,754 to $7,586
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 $2,754.23 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,754.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,754.23 | $2,754.23 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,715.35 Median $5,128.61 Typical High $8,128.31 | Professional | None | $3,715.35 | $5,128.61 | $8,128.31 |
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 $1,995.26 Median $2,951.21 Typical High $5,623.41 | Professional | None | $1,995.26 | $2,951.21 | $5,623.41 |
Medcost Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $6,606.93 | Professional | None | $3,388.44 | $3,388.44 | $6,606.93 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,311.31 | Facility | None | $724.44 | $724.44 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,630.27 | $3,630.78 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,238.72 | $2,344.23 |
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 $2,398.83 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,398.83 | $2,884.03 | $5,370.32 |
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 $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,318.26 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $1,071.52 | $1,318.26 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $426.58 | $524.81 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $371.54 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $295.12 | $371.54 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $371.54 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $371.54 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $371.54 Typical High $512.86 | Professional | AS · PA/NP assist | $295.12 | $371.54 | $512.86 |
Where North Carolina sits
The same service costs 5.1 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· 15th of 51
$4,365
AK $9,772TX $1,905
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.