How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $5,888 · 10th to 90th $3,890 to $10,233
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 $3,801.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,801.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,365.16 | Professional | None | $3,801.89 | $3,801.89 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,890.45 Median $6,760.83 Typical High $10,964.78 | Professional | None | $3,890.45 | $6,760.83 | $10,964.78 |
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 $3,890.45 Median $4,073.80 Typical High $7,585.78 | Professional | None | $3,890.45 | $4,073.80 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $9,120.11 | Professional | None | $5,888.44 | $5,888.44 | $9,120.11 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,165.95 | Facility | None | $724.44 | $724.44 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $4,570.88 | Professional | None | $3,630.78 | $4,073.80 | $4,570.88 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,630.27 | $2,754.23 |
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 $3,311.31 Median $3,981.07 Typical High $7,244.36 | Professional | None | $3,311.31 | $3,981.07 | $7,244.36 |
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 $1,905.46 Median $1,905.46 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 53 · Discontinued | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,819.70 Median $2,041.74 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $1,819.70 | $2,041.74 | $2,290.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $812.83 Typical High $912.01 | Professional | 80 · Assistant surgeon | $724.44 | $812.83 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $512.86 | $575.44 | $645.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $575.44 | $645.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | AS · PA/NP assist | $512.86 | $575.44 | $645.65 |
Where North Carolina sits
The same service costs 21.9 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
$5,888
AK $13,183TX $603
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.