How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $3,388 · 10th to 90th $2,188 to $6,026
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 $2,238.72 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,238.72 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,570.40 | Professional | None | $2,238.72 | $2,238.72 | $2,570.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $6,456.54 | Professional | None | $2,691.53 | $3,890.45 | $6,456.54 |
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 $2,137.96 Median $2,187.76 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,187.76 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $5,248.07 | Professional | None | $3,162.28 | $3,162.28 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,388.44 | Facility | None | $724.44 | $724.44 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,290.87 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
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 $1,862.09 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,862.09 | $2,238.72 | $4,265.80 |
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 $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 53 · Discontinued | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,148.15 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $1,071.52 | $1,148.15 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $457.09 Typical High $549.54 | Professional | 80 · Assistant surgeon | $426.58 | $457.09 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $302.00 | $316.23 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $316.23 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | AS · PA/NP assist | $302.00 | $316.23 | $380.19 |
Where North Carolina sits
The same service costs 20.9 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
$3,388
AK $7,586TX $363
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.