How much rates vary
Facilitymedian $1,622 · 10th to 90th $912 to $8,318Professionalmedian $2,291 · 10th to 90th $562 to $4,467
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 $1,174.90 Median $1,174.90 Typical High $1,513.56 | Facility | None | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,513.56 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $3,548.13 | Facility | None | $891.25 | $1,348.96 | $3,548.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $562.34 Median $2,818.38 Typical High $4,677.35 | Professional | None | $562.34 | $2,818.38 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,089.30 | Facility | None | $602.56 | $1,202.26 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,041.74 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,884.03 | $2,884.03 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,071.52 | $1,621.81 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,089.30 | $2,630.27 |
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 $1,174.90 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,737.80 | $3,467.37 |
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 $588.84 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $234.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $173.78 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,096.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $524.81 Median $812.83 Typical High $1,122.02 | Facility | 51 · Multiple procedures | $524.81 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,047.13 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $954.99 | $1,047.13 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $416.87 Typical High $758.58 | Professional | 80 · Assistant surgeon | $380.19 | $416.87 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $295.12 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $269.15 | $295.12 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $295.12 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $295.12 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $295.12 Typical High $524.81 | Professional | AS · PA/NP assist | $269.15 | $295.12 | $524.81 |
Where North Carolina sits
The same service costs 5.1 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· 12th of 51
$2,239
AK $4,786TX $933
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.