How much rates vary
Facilitymedian $851 · 10th to 90th $398 to $7,079Professionalmedian $6,607 · 10th to 90th $4,266 to $11,482
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 $4,168.69 Typical High $7,943.28 | Facility | None | $1,288.25 | $4,168.69 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,168.69 | $4,897.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4,265.80 Median $7,413.10 Typical High $12,022.64 | Professional | None | $4,265.80 | $7,413.10 | $12,022.64 |
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 $4,365.16 Median $4,365.16 Typical High $8,317.64 | Professional | None | $4,365.16 | $4,365.16 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $9,772.37 | Professional | None | $6,456.54 | $6,456.54 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $5,011.87 | Facility | None | $724.44 | $724.44 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $5,754.40 | Professional | None | $3,981.07 | $5,011.87 | $5,754.40 |
Oscar Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,168.69 | Professional | None | $3,981.07 | $3,981.07 | $4,168.69 |
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 $3,548.13 Median $4,265.80 Typical High $7,943.28 | Professional | None | $3,548.13 | $4,265.80 | $7,943.28 |
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 $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 53 · Discontinued | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 56 · Pre-op care only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $3,467.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,995.26 Median $2,818.38 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,995.26 | $2,818.38 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $794.33 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $562.34 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $562.34 | $812.83 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | AS · PA/NP assist | $562.34 | $812.83 | $812.83 |
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
$6,607
AK $14,125TX $676
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.