How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,344 · 10th to 90th $1,479 to $4,074
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 $1,513.56 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,513.56 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,479.11 | $2,630.27 | $4,365.16 |
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 $1,445.44 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,548.82 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,137.96 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,290.87 | Facility | None | $724.44 | $724.44 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,513.56 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
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 $1,258.93 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,513.56 | $2,884.03 |
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 $758.58 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $758.58 Typical High $912.01 | Professional | 51 · Multiple procedures | $724.44 | $758.58 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | 80 · Assistant surgeon | $288.40 | $302.00 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $213.80 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $199.53 | $213.80 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $213.80 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $213.80 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $213.80 Typical High $251.19 | Professional | AS · PA/NP assist | $199.53 | $213.80 | $251.19 |
Where North Carolina sits
The same service costs 5.1 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
$2,291
AK $5,129TX $1,000
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.