How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,042 · 10th to 90th $1,148 to $3,090
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 $1,148.15 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,041.74 | $3,311.31 |
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 $1,096.48 Median $1,174.90 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,174.90 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,659.59 | $1,659.59 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,737.80 | Facility | None | $724.44 | $724.44 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,202.26 | $1,445.44 |
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 $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 $977.24 Median $1,148.15 Typical High $2,187.76 | Professional | None | $977.24 | $1,148.15 | $2,187.76 |
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 $575.44 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $602.56 Typical High $741.31 | Professional | 51 · Multiple procedures | $537.03 | $602.56 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $295.12 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $165.96 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $151.36 | $165.96 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $165.96 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $165.96 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $165.96 Typical High $208.93 | Professional | AS · PA/NP assist | $151.36 | $165.96 | $208.93 |
Where North Carolina sits
The same service costs 5.6 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· 11th of 51
$2,042
AK $4,266TX $759
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.