How much rates vary
Facilitymedian $3,388 · 10th to 90th $603 to $8,128Professionalmedian $794 · 10th to 90th $23 to $1,585
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 $346.74 Median $602.56 Typical High $7,585.78 | Facility | None | $346.74 | $602.56 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $660.69 | Professional | None | $346.74 | $588.84 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $22.91 Median $851.14 Typical High $1,819.70 | Professional | None | $22.91 | $851.14 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $1,348.96 | Professional | None | $398.11 | $691.83 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,513.56 | Professional | None | $933.25 | $933.25 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $4,265.80 | Facility | None | $512.86 | $977.24 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,000.00 | Professional | None | $478.63 | $812.83 | $1,000.00 |
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 $338.84 Median $616.60 Typical High $1,230.27 | Professional | None | $338.84 | $616.60 | $1,230.27 |
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 $173.78 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $173.78 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $69.18 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $51.29 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $34.67 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $239.88 | $398.11 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $257.04 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $426.58 Typical High $851.14 | Professional | 51 · Multiple procedures | $239.88 | $426.58 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $169.82 Typical High $346.74 | Professional | 80 · Assistant surgeon | $95.50 | $169.82 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $67.61 Median $120.23 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $67.61 | $120.23 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $67.61 Median $120.23 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $67.61 | $120.23 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $120.23 Typical High $239.88 | Professional | AS · PA/NP assist | $67.61 | $120.23 | $239.88 |
Where North Carolina sits
The same service costs 4.9 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· 14th of 51
$813
AK $1,862TX $380
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.