How much rates vary
Facilitymedian $776 · 10th to 90th $398 to $6,761Professionalmedian $1,000 · 10th to 90th $661 to $1,738
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 $660.69 Median $660.69 Typical High $7,943.28 | Facility | None | $660.69 | $660.69 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | None | $660.69 | $660.69 | $776.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,862.09 | Professional | None | $794.33 | $1,122.02 | $1,862.09 |
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 $645.65 Median $660.69 Typical High $1,288.25 | Professional | None | $645.65 | $660.69 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,548.82 | Professional | None | $954.99 | $954.99 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,047.13 | Facility | None | $724.44 | $724.44 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $794.33 | Professional | None | $630.96 | $741.31 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | None | $676.08 | $676.08 | $707.95 |
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 $549.54 Median $660.69 Typical High $1,230.27 | Professional | None | $549.54 | $660.69 | $1,230.27 |
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 $331.13 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $371.54 Typical High $478.63 | Professional | 51 · Multiple procedures | $316.23 | $371.54 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $194.98 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $104.71 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $87.10 | $104.71 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $104.71 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $104.71 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $104.71 Typical High $138.04 | Professional | AS · PA/NP assist | $87.10 | $104.71 | $138.04 |
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· 15th of 51
$1,000
AK $2,512TX $468
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.