How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,239 · 10th to 90th $1,380 to $3,802
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 $1,380.38 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,380.38 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,445.44 | $2,454.71 | $3,981.07 |
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 $1,380.38 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,445.44 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,089.30 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,187.76 | Facility | None | $724.44 | $724.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,445.44 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,258.93 | $1,318.26 |
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 $1,202.26 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,445.44 | $2,630.27 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $724.44 Typical High $912.01 | Professional | 51 · Multiple procedures | $660.69 | $724.44 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $295.12 Typical High $363.08 | Professional | 80 · Assistant surgeon | $263.03 | $295.12 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $204.17 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $186.21 | $204.17 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $204.17 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $204.17 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $186.21 | $204.17 | $257.04 |
Where North Carolina sits
The same service costs 5.2 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· 14th of 51
$2,239
AK $4,898TX $933
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.