How much rates vary
Facilitymedian $8,710 · 10th to 90th $724 to $19,055Professionalmedian $2,042 · 10th to 90th $1,148 to $3,548
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 $1,230.27 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,230.27 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,230.27 | $1,479.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,760.83 Median $10,000.00 Typical High $14,125.38 | Facility | None | $6,760.83 | $10,000.00 | $14,125.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,148.15 | $2,290.87 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $12,302.69 | Facility | None | $602.56 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,318.26 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,995.26 | $1,995.26 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $10,232.93 | Facility | None | $724.44 | $724.44 | $10,232.93 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,548.82 | $1,737.80 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,023.29 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,232.93 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,232.93 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,288.25 | $2,344.23 |
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 $616.60 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $776.25 Typical High $870.96 | Professional | 51 · Multiple procedures | $588.84 | $776.25 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $309.03 Typical High $346.74 | Professional | 80 · Assistant surgeon | $234.42 | $309.03 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $218.78 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $165.96 | $218.78 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $218.78 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $218.78 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $218.78 Typical High $245.47 | Professional | AS · PA/NP assist | $165.96 | $218.78 | $245.47 |
Where North Carolina sits
The same service costs 25.7 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
$2,089
AK $5,129TX $200
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.