How much rates vary
Facilitymedian $1,549 · 10th to 90th $851 to $8,318Professionalmedian $2,455 · 10th to 90th $1,549 to $4,677
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 $1,258.93 Median $1,258.93 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,548.82 | $1,659.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $831.76 Median $1,258.93 Typical High $3,311.31 | Facility | None | $831.76 | $1,258.93 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $5,011.87 | Professional | None | $1,949.84 | $2,884.03 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,949.84 | Facility | None | $602.56 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,187.76 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,630.78 | Professional | None | $3,235.94 | $3,235.94 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,454.71 | Facility | None | $1,000.00 | $1,548.82 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,862.09 | $2,089.30 | $2,691.53 |
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 $1,230.27 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,230.27 | $1,819.70 | $3,630.78 |
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 $630.96 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,174.90 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $489.78 Median $776.25 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $489.78 | $776.25 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,047.13 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,047.13 | $1,047.13 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | 80 · Assistant surgeon | $416.87 | $416.87 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $295.12 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $288.40 | $295.12 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $295.12 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $295.12 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $295.12 Typical High $562.34 | Professional | AS · PA/NP assist | $288.40 | $295.12 | $562.34 |
Where North Carolina sits
The same service costs 5.5 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
$2,399
AK $5,129TX $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.