How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $1,549 · 10th to 90th $1,000 to $2,692
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 $1,000.00 Median $1,000.00 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,000.00 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,737.80 | $2,818.38 |
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 $954.99 Median $1,000.00 Typical High $1,949.84 | Professional | None | $954.99 | $1,000.00 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,412.54 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Facility | None | $724.44 | $724.44 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,230.27 | Professional | None | $933.25 | $1,122.02 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,023.29 | $1,071.52 |
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 $831.76 Median $1,000.00 Typical High $1,862.09 | Professional | None | $831.76 | $1,000.00 | $1,862.09 |
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 $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $549.54 Typical High $724.44 | Professional | 51 · Multiple procedures | $467.74 | $549.54 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $295.12 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $131.83 | $162.18 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $162.18 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $204.17 |
Where North Carolina sits
The same service costs 4.9 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· 15th of 51
$1,514
AK $3,548TX $724
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.