How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,818 · 10th to 90th $1,820 to $4,677
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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,698.24 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,187.76 | $3,090.30 | $4,897.79 |
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 $1,819.70 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,819.70 | $1,862.09 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $4,073.80 | Professional | None | $2,818.38 | $2,818.38 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,754.23 | Facility | None | $724.44 | $724.44 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,621.81 | $2,041.74 | $2,290.87 |
Oscar Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,995.26 | $1,995.26 | $2,089.30 |
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 $1,479.11 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,778.28 | $3,235.94 |
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 $851.14 Median $851.14 Typical High $1,000.00 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 53 · Discontinued | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,023.29 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $812.83 | $1,023.29 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $426.58 Typical High $549.54 | Professional | 80 · Assistant surgeon | $323.59 | $426.58 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $302.00 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $229.09 | $302.00 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $302.00 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $302.00 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $302.00 Typical High $389.05 | Professional | AS · PA/NP assist | $229.09 | $302.00 | $389.05 |
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
$2,754
AK $6,026TX $1,122
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.