How much rates vary
Facilitymedian $2,570 · 10th to 90th $724 to $19,055Professionalmedian $2,512 · 10th to 90th $1,259 to $3,388
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 $1,258.93 Median $1,584.89 Typical High $21,877.62 | Facility | None | $1,258.93 | $1,584.89 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,691.53 | $3,630.78 |
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 $1,230.27 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,318.26 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,905.46 | $1,905.46 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,995.26 | Facility | None | $724.44 | $724.44 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,445.44 | $1,621.81 |
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 $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,288.25 | $2,398.83 |
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 $630.96 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $724.44 Typical High $870.96 | Professional | 51 · Multiple procedures | $602.56 | $724.44 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $169.82 | $204.17 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $204.17 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $245.47 |
Where North Carolina sits
The same service costs 26.3 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· 8th of 51
$2,512
AK $5,248TX $200
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.