How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,239 · 10th to 90th $1,413 to $3,548
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 $1,318.26 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,318.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,511.89 | $3,801.89 |
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 $1,412.54 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,479.11 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,137.96 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,089.30 | Facility | None | $724.44 | $724.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
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 $1,174.90 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,479.11 | $2,511.89 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $776.25 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $616.60 | $776.25 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $316.23 Typical High $398.11 | Professional | 80 · Assistant surgeon | $245.47 | $316.23 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $223.87 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $173.78 | $223.87 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $223.87 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $223.87 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $223.87 Typical High $275.42 | Professional | AS · PA/NP assist | $173.78 | $223.87 | $275.42 |
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· 13th of 51
$2,239
AK $4,786TX $891
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.