How much rates vary
Facilitymedian $4,571 · 10th to 90th $759 to $11,220Professionalmedian $1,259 · 10th to 90th $708 to $2,239
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 $758.58 Median $1,778.28 Typical High $12,589.25 | Facility | None | $758.58 | $1,778.28 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | None | $758.58 | $758.58 | $912.01 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,981.07 | $5,888.44 | $7,943.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $707.95 Median $1,412.54 Typical High $2,238.72 | Professional | None | $707.95 | $1,412.54 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $4,365.16 Typical High $7,244.36 | Facility | None | $891.25 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,479.11 | Professional | None | $812.83 | $831.76 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,258.93 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,165.95 | Facility | None | $724.44 | $724.44 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,122.02 | Professional | None | $724.44 | $891.25 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,513.56 | Professional | None | $645.65 | $794.33 | $1,513.56 |
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 $380.19 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $457.09 Typical High $616.60 | Professional | 51 · Multiple procedures | $354.81 | $457.09 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $186.21 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $100.00 | $128.82 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $128.82 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $173.78 |
Where North Carolina sits
The same service costs 25.1 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· 13th of 51
$1,288
AK $3,090TX $123
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.