How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $3,162 · 10th to 90th $1,738 to $4,571
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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,698.24 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,187.76 | $3,162.28 | $4,897.79 |
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 $1,737.80 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,737.80 | $1,778.28 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,981.07 | Professional | None | $2,630.27 | $2,630.27 | $3,981.07 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,691.53 | Facility | None | $724.44 | $724.44 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,862.09 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
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 $1,445.44 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,778.28 | $3,388.44 |
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 $851.14 Median $851.14 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $912.01 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $794.33 | $912.01 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | 80 · Assistant surgeon | $316.23 | $371.54 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $223.87 | $257.04 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $257.04 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | AS · PA/NP assist | $223.87 | $257.04 | $309.03 |
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
$3,162
AK $5,888TX $1,096
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.