How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $1,862 · 10th to 90th $776 to $3,020
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 $1,122.02 Median $1,122.02 Typical High $7,943.28 | Facility | None | $1,122.02 | $1,122.02 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,995.26 Typical High $3,235.94 | Professional | None | $776.25 | $1,995.26 | $3,235.94 |
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 $1,202.26 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,230.27 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,862.09 | $1,862.09 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,778.28 | Facility | None | $724.44 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,380.38 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
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 $954.99 Median $1,174.90 Typical High $2,137.96 | Professional | None | $954.99 | $1,174.90 | $2,137.96 |
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 $562.34 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $691.83 Typical High $851.14 | Professional | 51 · Multiple procedures | $537.03 | $691.83 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $194.98 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $147.91 | $194.98 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $194.98 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $194.98 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $194.98 Typical High $239.88 | Professional | AS · PA/NP assist | $147.91 | $194.98 | $239.88 |
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· 13th of 51
$1,862
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.