How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $10,715Professionalmedian $2,291 · 10th to 90th $1,585 to $4,571
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 $1,584.89 Median $1,621.81 Typical High $10,471.29 | Facility | None | $1,584.89 | $1,621.81 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $10,715.19 | Facility | None | $2,454.71 | $3,388.44 | $10,715.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $4,570.88 | Professional | None | $1,584.89 | $3,019.95 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,495.41 Typical High $9,120.11 | Facility | None | $602.56 | $5,495.41 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $4,073.80 | Professional | None | $1,862.09 | $1,905.46 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,890.45 | Professional | None | $2,818.38 | $2,818.38 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,995.26 | $3,162.28 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,995.26 | $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 $1,380.38 Median $1,862.09 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,862.09 | $3,981.07 |
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 $812.83 Median $812.83 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,318.26 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,584.89 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $1,000.00 | $1,584.89 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,000.00 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $1,000.00 | $1,000.00 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $407.38 Typical High $776.25 | Professional | 80 · Assistant surgeon | $398.11 | $407.38 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $281.84 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $281.84 | $281.84 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $281.84 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $281.84 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $281.84 Typical High $537.03 | Professional | AS · PA/NP assist | $281.84 | $281.84 | $537.03 |
Where North Carolina sits
The same service costs 20.4 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· 22nd of 51
$2,344
AK $6,607TX $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.