How much rates vary
Facilitymedian $1,950 · 10th to 90th $813 to $5,623Professionalmedian $955 · 10th to 90th $617 to $1,905
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 $524.81 Median $616.60 Typical High $10,964.78 | Facility | None | $524.81 | $616.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $776.25 | Professional | None | $524.81 | $616.60 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,949.84 | Professional | None | $758.58 | $1,230.27 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $4,466.84 | Facility | None | $1,258.93 | $3,548.13 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,513.56 | Professional | None | $691.83 | $776.25 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,122.02 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,288.25 Typical High $2,290.87 | Facility | None | $741.31 | $1,288.25 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,122.02 | Professional | None | $724.44 | $912.01 | $1,122.02 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,479.11 | Professional | None | $512.86 | $741.31 | $1,479.11 |
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 $257.04 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $489.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $549.54 Median $676.08 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $549.54 | $676.08 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | 51 · Multiple procedures | $363.08 | $457.09 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $302.00 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $128.82 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $100.00 | $128.82 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $128.82 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $128.82 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $213.80 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $213.80 |
Where North Carolina sits
The same service costs 6.2 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· 10th of 51
$1,023
AK $2,570TX $417
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.