How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,399 · 10th to 90th $1,413 to $3,890
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 $1,412.54 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,412.54 | $2,630.27 | $4,168.69 |
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 $1,380.38 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,548.82 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,137.96 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,187.76 | Facility | None | $724.44 | $724.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,479.11 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,258.93 | $1,318.26 |
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 $1,258.93 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,548.82 | $2,754.23 |
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 $707.95 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $724.44 Typical High $933.25 | Professional | 51 · Multiple procedures | $676.08 | $724.44 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $316.23 Typical High $371.54 | Professional | 80 · Assistant surgeon | $269.15 | $316.23 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $223.87 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $190.55 | $223.87 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $223.87 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $223.87 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $263.03 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $263.03 |
Where North Carolina sits
The same service costs 5.0 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
$2,291
AK $5,012TX $1,000
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.