How much rates vary
Facilitymedian $6,166 · 10th to 90th $955 to $13,490Professionalmedian $4,571 · 10th to 90th $2,692 to $7,586
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 $2,570.40 Typical High $10,471.29 | Facility | None | $1,584.89 | $2,570.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,570.40 | $2,570.40 | $3,019.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $12,022.64 | Facility | None | $4,677.35 | $7,762.47 | $12,022.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,162.28 Median $4,570.88 Typical High $7,585.78 | Professional | None | $3,162.28 | $4,570.88 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,760.83 Typical High $11,220.18 | Facility | None | $602.56 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,456.54 | Professional | None | $3,019.95 | $3,019.95 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $6,025.60 | Professional | None | $4,570.88 | $4,570.88 | $6,025.60 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $12,589.25 | Facility | None | $602.56 | $954.99 | $12,589.25 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $4,570.88 | Professional | None | $3,090.30 | $3,388.44 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $6,309.57 | Professional | None | $2,238.72 | $2,951.21 | $6,309.57 |
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 $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,659.59 Median $1,698.24 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $1,659.59 | $1,698.24 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $676.08 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $660.69 | $676.08 | $1,230.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $478.63 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $457.09 | $478.63 | $870.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $478.63 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $478.63 | $870.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $478.63 Typical High $870.96 | Professional | AS · PA/NP assist | $457.09 | $478.63 | $870.96 |
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· 11th of 51
$4,571
AK $10,715TX $1,230
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.