How much rates vary
Facilitymedian $2,818 · 10th to 90th $724 to $19,055Professionalmedian $2,512 · 10th to 90th $1,514 to $4,074
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 $1,513.56 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,513.56 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,754.23 | $4,365.16 |
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 $1,584.89 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,584.89 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,089.30 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,238.72 | Facility | None | $724.44 | $724.44 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,513.56 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,584.89 | $2,884.03 |
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 $741.31 Median $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $758.58 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $707.95 | $758.58 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $213.80 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $199.53 | $213.80 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $213.80 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $213.80 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $213.80 Typical High $281.84 | Professional | AS · PA/NP assist | $199.53 | $213.80 | $281.84 |
Where North Carolina sits
The same service costs 6.3 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
$2,512
AK $6,166TX $977
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.