How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,089 · 10th to 90th $1,288 to $3,467
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 $1,288.25 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,288.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,288.25 | $2,290.87 | $3,715.35 |
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 $1,318.26 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,348.96 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,995.26 | $1,995.26 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,041.74 | Facility | None | $724.44 | $724.44 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,288.25 | $1,348.96 |
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 $1,122.02 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,348.96 | $2,454.71 |
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 $645.65 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $741.31 Typical High $933.25 | Professional | 51 · Multiple procedures | $616.60 | $741.31 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $316.23 Typical High $371.54 | Professional | 80 · Assistant surgeon | $245.47 | $316.23 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $223.87 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $169.82 | $223.87 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $223.87 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $223.87 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $223.87 Typical High $263.03 | Professional | AS · PA/NP assist | $169.82 | $223.87 | $263.03 |
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· 12th of 51
$2,089
AK $4,571TX $851
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.