How much rates vary
Facilitymedian $316 · 10th to 90th $110 to $891Professionalmedian $457 · 10th to 90th $339 to $1,096
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 $338.84 Median $436.52 Typical High $5,248.07 | Facility | None | $338.84 | $436.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $436.52 | Professional | None | $338.84 | $389.05 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $602.56 | Facility | None | $151.36 | $229.09 | $602.56 |
BCBS North Carolina Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $1,148.15 | Professional | None | $346.74 | $467.74 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $707.95 | Facility | None | $263.03 | $398.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $977.24 | Professional | None | $380.19 | $489.78 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | None | $676.08 | $676.08 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $199.53 Typical High $549.54 | Facility | None | $138.04 | $199.53 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $588.84 | Professional | None | $371.54 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $954.99 | Professional | None | $309.03 | $426.58 | $954.99 |
12 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 $169.82 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $302.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $64.57 Median $100.00 Typical High $218.78 | Facility | 51 · Multiple procedures | $64.57 | $100.00 | $218.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $295.12 Typical High $389.05 | Professional | 51 · Multiple procedures | $186.21 | $295.12 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $117.49 Typical High $154.88 | Professional | 80 · Assistant surgeon | $75.86 | $117.49 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $52.48 Median $81.28 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $52.48 | $81.28 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $52.48 Median $81.28 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $52.48 | $81.28 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $81.28 Typical High $109.65 | Professional | AS · PA/NP assist | $52.48 | $81.28 | $109.65 |
Where North Carolina sits
The same service costs 6.0 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· 34th of 51
$437
AK $1,445TX $240
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.