How much rates vary
Facilitymedian $5,012 · 10th to 90th $955 to $10,965Professionalmedian $2,630 · 10th to 90th $1,349 to $11,220
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 $1,348.96 Median $1,348.96 Typical High $10,471.29 | Facility | None | $1,348.96 | $1,348.96 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $10,000.00 | Facility | None | $3,890.45 | $6,309.57 | $10,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $11,220.18 | Professional | None | $1,621.81 | $3,162.28 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $9,332.54 | Facility | None | $602.56 | $5,623.41 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,513.56 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,187.76 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $10,471.29 | Facility | None | $602.56 | $954.99 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,698.24 | $2,238.72 |
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 $1,148.15 Median $1,479.11 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,479.11 | $3,311.31 |
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 $676.08 Median $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $851.14 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $758.58 | $851.14 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $338.84 Typical High $645.65 | Professional | 80 · Assistant surgeon | $302.00 | $338.84 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $239.88 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $208.93 | $239.88 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $239.88 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $239.88 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $239.88 Typical High $457.09 | Professional | AS · PA/NP assist | $208.93 | $239.88 | $457.09 |
Where North Carolina sits
The same service costs 17.0 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· 8th of 51
$2,692
AK $5,495TX $324
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.