How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,230 to $10,965Professionalmedian $2,512 · 10th to 90th $1,698 to $5,012
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 $1,778.28 Typical High $10,471.29 | Facility | None | $1,584.89 | $1,778.28 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,801.89 Median $6,309.57 Typical High $9,772.37 | Facility | None | $3,801.89 | $6,309.57 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $5,128.61 | Professional | None | $1,698.24 | $3,235.94 | $5,128.61 |
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 $2,187.76 Median $2,290.87 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,290.87 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $4,265.80 | Professional | None | $3,311.31 | $3,311.31 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $7,244.36 Typical High $14,454.40 | Facility | None | $1,778.28 | $7,244.36 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,511.89 | $2,951.21 |
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 $1,513.56 Median $2,089.30 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,089.30 | $4,365.16 |
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 $891.25 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,258.93 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,174.90 | $1,258.93 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $501.19 Typical High $851.14 | Professional | 80 · Assistant surgeon | $467.74 | $501.19 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $346.74 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $331.13 | $346.74 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $346.74 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $346.74 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $346.74 Typical High $602.56 | Professional | AS · PA/NP assist | $331.13 | $346.74 | $602.56 |
Where North Carolina sits
The same service costs 20.0 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· 20th of 51
$2,692
AK $7,244TX $363
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.