How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,138 · 10th to 90th $1,318 to $3,548
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 $1,258.93 Median $1,258.93 Typical High $7,943.28 | Facility | None | $1,258.93 | $1,258.93 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,398.83 | $3,715.35 |
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 $1,288.25 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,380.38 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,949.84 | $1,949.84 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,041.74 | Facility | None | $724.44 | $724.44 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
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 $1,122.02 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,380.38 | $2,454.71 |
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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $724.44 Typical High $977.24 | Professional | 51 · Multiple procedures | $616.60 | $724.44 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $323.59 Typical High $389.05 | Professional | 80 · Assistant surgeon | $245.47 | $323.59 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $229.09 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $169.82 | $229.09 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $229.09 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $229.09 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $229.09 Typical High $275.42 | Professional | AS · PA/NP assist | $169.82 | $229.09 | $275.42 |
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· 12th of 51
$2,138
AK $4,571TX $851
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.