How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $1,820 · 10th to 90th $1,148 to $3,162
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 $1,174.90 Median $1,174.90 Typical High $7,943.28 | Facility | None | $1,174.90 | $1,174.90 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,174.90 | $2,089.30 | $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 $1,071.52 Median $1,202.26 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,202.26 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,621.81 | $2,754.23 |
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 $1,096.48 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,148.15 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | None | $1,000.00 | $1,000.00 | $1,047.13 |
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 $1,000.00 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,174.90 | $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 $691.83 | Professional | 52 · Reduced service | $575.44 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $575.44 Typical High $724.44 | Professional | 51 · Multiple procedures | $549.54 | $575.44 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $229.09 Typical High $288.40 | Professional | 80 · Assistant surgeon | $218.78 | $229.09 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $154.88 | $162.18 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $162.18 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $154.88 | $162.18 | $204.17 |
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
$1,820
AK $4,266TX $794
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.