How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $3,236 · 10th to 90th $1,862 to $4,266
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 $1,548.82 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,548.82 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $4,570.88 | Professional | None | $2,041.74 | $3,388.44 | $4,570.88 |
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 $1,862.09 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,862.09 | $1,905.46 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,630.78 | Professional | None | $2,884.03 | $2,884.03 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Facility | None | $724.44 | $724.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,479.11 | $2,137.96 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,398.83 | $2,398.83 | $2,511.89 |
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 $1,412.54 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,819.70 | $3,019.95 |
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 $776.25 Median $776.25 Typical High $912.01 | Professional | 52 · Reduced service | $776.25 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $1,122.02 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $724.44 | $1,122.02 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $446.68 Typical High $549.54 | Professional | 80 · Assistant surgeon | $295.12 | $446.68 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $316.23 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $204.17 | $316.23 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $316.23 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $316.23 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $316.23 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $316.23 | $389.05 |
Where North Carolina sits
The same service costs 5.4 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· 6th of 51
$3,236
AK $5,623TX $1,047
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.