How much rates vary
Facilitymedian $2,138 · 10th to 90th $955 to $7,079Professionalmedian $977 · 10th to 90th $490 to $2,042
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 $724.44 Median $1,288.25 Typical High $11,481.54 | Facility | None | $724.44 | $1,288.25 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
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 $489.78 Median $1,230.27 Typical High $2,089.30 | Professional | None | $489.78 | $1,230.27 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $4,168.69 Typical High $6,025.60 | Facility | None | $1,258.93 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,659.59 | Professional | None | $758.58 | $794.33 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,122.02 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $5,495.41 | Facility | None | $1,096.48 | $1,288.25 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,202.26 | Professional | None | $776.25 | $831.76 | $1,202.26 |
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 $630.96 Median $794.33 Typical High $1,819.70 | Professional | None | $630.96 | $794.33 | $1,819.70 |
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 $363.08 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $602.56 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $549.54 Median $676.08 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $549.54 | $676.08 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $416.87 Typical High $870.96 | Professional | 51 · Multiple procedures | $389.05 | $416.87 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $169.82 Typical High $354.81 | Professional | 80 · Assistant surgeon | $154.88 | $169.82 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $117.49 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $109.65 | $117.49 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $117.49 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $117.49 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $117.49 Typical High $245.47 | Professional | AS · PA/NP assist | $109.65 | $117.49 | $245.47 |
Where North Carolina sits
The same service costs 17.4 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· 21st of 51
$1,072
AK $3,020TX $174
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.