How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,089 · 10th to 90th $1,318 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 $1,318.26 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,318.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,513.56 | $2,344.23 | $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 $1,230.27 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,348.96 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,862.09 | $1,862.09 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,949.84 | Facility | None | $724.44 | $724.44 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,318.26 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,148.15 | $1,202.26 |
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 $2,511.89 | Professional | None | $1,122.02 | $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 $776.25 | Professional | 52 · Reduced service | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $263.03 | $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 $234.42 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $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 $660.69 Typical High $851.14 | Professional | 51 · Multiple procedures | $630.96 | $660.69 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $269.15 Typical High $338.84 | Professional | 80 · Assistant surgeon | $251.19 | $269.15 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $177.83 | $186.21 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $186.21 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | AS · PA/NP assist | $177.83 | $186.21 | $234.42 |
Where North Carolina sits
The same service costs 5.2 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 $891
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.