How much rates vary
Facilitymedian $2,239 · 10th to 90th $891 to $6,310Professionalmedian $1,778 · 10th to 90th $1,479 to $3,981
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 $1,584.89 Median $1,737.80 Typical High $10,471.29 | Facility | None | $1,584.89 | $1,737.80 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,737.80 | $1,778.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,479.11 | $1,698.24 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $3,890.45 | Facility | None | $794.33 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,778.28 | $1,819.70 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,570.40 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $3,801.89 | Facility | None | $741.31 | $1,071.52 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,089.30 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $4,073.80 | Professional | None | $1,380.38 | $1,778.28 | $4,073.80 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $537.03 Typical High $1,905.46 | Facility | 51 · Multiple procedures | $363.08 | $537.03 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,023.29 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $812.83 | $1,023.29 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $416.87 Typical High $575.44 | Professional | 80 · Assistant surgeon | $323.59 | $416.87 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $288.40 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $229.09 | $288.40 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $288.40 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $288.40 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $407.38 |
Where North Carolina sits
The same service costs 8.7 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· 40th of 51
$1,778
AK $7,244TX $832
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.