How much rates vary
Facilitymedian $851 · 10th to 90th $398 to $6,761Professionalmedian $3,890 · 10th to 90th $2,455 to $6,607
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 $2,454.71 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,454.71 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $7,079.46 | Professional | None | $3,090.30 | $4,365.16 | $7,079.46 |
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 $2,344.23 Median $2,570.40 Typical High $4,786.30 | Professional | None | $2,344.23 | $2,570.40 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,754.40 | Professional | None | $3,548.13 | $3,548.13 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,884.03 | Facility | None | $724.44 | $724.44 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,570.40 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,238.72 | $2,344.23 |
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 $2,089.30 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,089.30 | $2,511.89 | $4,677.35 |
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 $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,258.93 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $1,148.15 | $1,258.93 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $512.86 Typical High $630.96 | Professional | 80 · Assistant surgeon | $457.09 | $512.86 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $354.81 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $323.59 | $354.81 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $354.81 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $354.81 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $354.81 Typical High $436.52 | Professional | AS · PA/NP assist | $323.59 | $354.81 | $436.52 |
Where North Carolina sits
The same service costs 21.4 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· 13th of 51
$3,890
AK $8,318TX $389
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.