How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,138 · 10th to 90th $1,349 to $3,631
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 $1,348.96 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,348.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,398.83 | $3,801.89 |
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 $1,288.25 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,380.38 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,949.84 | $1,949.84 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,089.30 | Facility | None | $724.44 | $724.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,412.54 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
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 $1,148.15 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,348.96 | $2,511.89 |
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 $660.69 Median $660.69 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $707.95 Typical High $870.96 | Professional | 51 · Multiple procedures | $630.96 | $707.95 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $251.19 | $288.40 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $177.83 | $199.53 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $199.53 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | AS · PA/NP assist | $177.83 | $199.53 | $245.47 |
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
$2,089
AK $4,677TX $871
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.