How much rates vary
Facilitymedian $851 · 10th to 90th $380 to $5,248Professionalmedian $6,026 · 10th to 90th $3,548 to $9,550
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 $3,467.37 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,467.37 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,168.69 | Professional | None | $3,467.37 | $3,467.37 | $4,168.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,548.13 Median $6,309.57 Typical High $10,000.00 | Professional | None | $3,548.13 | $6,309.57 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $22,908.68 | Professional | None | $22,908.68 | $22,908.68 | $22,908.68 |
Medcost Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $8,317.64 | Professional | None | $5,370.32 | $5,370.32 | $8,317.64 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,168.69 | Facility | None | $724.44 | $724.44 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $4,365.16 Typical High $4,786.30 | Professional | None | $3,311.31 | $4,365.16 | $4,786.30 |
Oscar Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,388.44 | $3,467.37 |
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 $3,019.95 Median $3,548.13 Typical High $6,760.83 | Professional | None | $3,019.95 | $3,548.13 | $6,760.83 |
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 $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 53 · Discontinued | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $616.60 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,659.59 Median $2,398.83 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $1,659.59 | $2,398.83 | $2,398.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $954.99 Typical High $954.99 | Professional | 80 · Assistant surgeon | $660.69 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $467.74 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $467.74 | $676.08 | $676.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | AS · PA/NP assist | $467.74 | $676.08 | $676.08 |
Where North Carolina sits
The same service costs 27.5 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· 13th of 51
$5,888
AK $14,454TX $525
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.