How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $1,698 · 10th to 90th $955 to $2,818
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 $1,047.13 Median $1,047.13 Typical High $7,943.28 | Facility | None | $1,047.13 | $1,047.13 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
BCBS North Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,951.21 | Professional | None | $954.99 | $1,862.09 | $2,951.21 |
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 $1,071.52 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,071.52 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,621.81 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,659.59 | Facility | None | $724.44 | $724.44 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,230.27 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
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 $891.25 Median $1,071.52 Typical High $1,995.26 | Professional | None | $891.25 | $1,071.52 | $1,995.26 |
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 $524.81 Median $524.81 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $602.56 Typical High $776.25 | Professional | 51 · Multiple procedures | $501.19 | $602.56 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $257.04 Typical High $323.59 | Professional | 80 · Assistant surgeon | $199.53 | $257.04 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $177.83 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $138.04 | $177.83 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $177.83 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $177.83 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $138.04 | $177.83 | $223.87 |
Where North Carolina sits
The same service costs 24.5 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· 15th of 51
$1,660
AK $4,266TX $174
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.