How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,570 · 10th to 90th $1,622 to $4,365
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 $1,621.81 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,621.81 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,677.35 | Professional | None | $2,089.30 | $2,884.03 | $4,677.35 |
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 $1,584.89 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,584.89 | $1,659.59 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,890.45 | Professional | None | $2,398.83 | $2,398.83 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,511.89 | Facility | None | $724.44 | $724.44 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,698.24 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,348.96 | $1,412.54 |
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 $1,380.38 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,659.59 | $3,090.30 |
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 $812.83 Median $812.83 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $309.03 | $338.84 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $234.42 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $218.78 | $234.42 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $234.42 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $234.42 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $234.42 Typical High $275.42 | Professional | AS · PA/NP assist | $218.78 | $234.42 | $275.42 |
Where North Carolina sits
The same service costs 20.4 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· 15th of 51
$2,512
AK $5,495TX $269
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.