How much rates vary
Facilitymedian $1,349 · 10th to 90th $832 to $6,761Professionalmedian $1,995 · 10th to 90th $1,318 to $3,890
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 $1,000.00 Median $1,000.00 Typical High $1,318.26 | Facility | None | $1,000.00 | $1,000.00 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,318.26 | $1,380.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,548.82 | Facility | None | $758.58 | $1,122.02 | $1,548.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,584.89 | $2,454.71 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,905.46 | Facility | None | $602.56 | $1,071.52 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,737.80 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,570.40 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,089.30 | Facility | None | $977.24 | $1,445.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,778.28 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,513.56 | $3,019.95 |
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 $501.19 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $204.17 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $707.95 | $912.01 | $954.99 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $467.74 Median $724.44 Typical High $1,000.00 | Facility | 51 · Multiple procedures | $467.74 | $724.44 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $891.25 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $831.76 | $891.25 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $354.81 Typical High $660.69 | Professional | 80 · Assistant surgeon | $331.13 | $354.81 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $251.19 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $234.42 | $251.19 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $251.19 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $251.19 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $251.19 Typical High $457.09 | Professional | AS · PA/NP assist | $234.42 | $251.19 | $457.09 |
Where North Carolina sits
The same service costs 5.0 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· 11th of 51
$1,950
AK $4,169TX $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.