How much rates vary
Facilitymedian $1,445 · 10th to 90th $537 to $4,074Professionalmedian $3,236 · 10th to 90th $2,512 to $6,026
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 $2,630.27 Typical High $10,471.29 | Facility | None | $1,584.89 | $2,630.27 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,630.27 | $2,691.53 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,819.70 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,570.40 Median $5,011.87 Typical High $6,309.57 | Professional | None | $2,570.40 | $5,011.87 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $2,754.23 | Facility | None | $741.31 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $6,760.83 | Professional | None | $2,818.38 | $2,951.21 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,570.88 | Professional | None | $4,265.80 | $4,265.80 | $4,570.88 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,019.95 | Facility | None | $933.25 | $1,445.44 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,162.28 | $3,981.07 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $6,165.95 | Professional | None | $2,137.96 | $2,691.53 | $6,165.95 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $467.74 Median $724.44 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $467.74 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,584.89 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $1,258.93 | $1,584.89 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $870.96 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $354.81 | $446.68 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $446.68 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | AS · PA/NP assist | $354.81 | $446.68 | $616.60 |
Where North Carolina sits
The same service costs 15.8 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· 23rd of 51
$3,020
AK $8,128TX $513
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.