How much rates vary
Facilitymedian $933 · 10th to 90th $398 to $10,965Professionalmedian $3,388 · 10th to 90th $1,778 to $4,786
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 $1,584.89 Median $1,778.28 Typical High $21,877.62 | Facility | None | $1,584.89 | $1,778.28 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,344.23 | $3,388.44 | $5,128.61 |
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 $1,778.28 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,778.28 | $1,862.09 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,691.53 | $2,691.53 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,818.38 | Facility | None | $724.44 | $724.44 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,698.24 | $2,041.74 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
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 $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,819.70 | $3,467.37 |
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 $891.25 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | 53 · Discontinued | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,023.29 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $851.14 | $1,023.29 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $407.38 Typical High $478.63 | Professional | 80 · Assistant surgeon | $338.84 | $407.38 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $234.42 | $288.40 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $288.40 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $331.13 |
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· 9th of 51
$3,388
AK $6,310TX $1,175
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.