How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,202 to $11,749Professionalmedian $3,890 · 10th to 90th $2,692 to $7,762
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 $2,754.23 Typical High $10,471.29 | Facility | None | $1,584.89 | $2,754.23 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,754.23 | $3,235.94 |
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 $2,691.53 Median $5,011.87 Typical High $7,762.47 | Professional | None | $2,691.53 | $5,011.87 | $7,762.47 |
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 $3,311.31 Median $3,388.44 Typical High $6,606.93 | Professional | None | $3,311.31 | $3,388.44 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Medcost Setting Facility Modifier None Typical Low $2,754.23 Median $10,232.93 Typical High $14,454.40 | Facility | None | $2,754.23 | $10,232.93 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $4,570.88 | Professional | None | $3,388.44 | $3,630.78 | $4,570.88 |
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 $2,398.83 Median $3,162.28 Typical High $6,760.83 | Professional | None | $2,398.83 | $3,162.28 | $6,760.83 |
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 $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $1,819.70 Typical High $3,311.31 | Professional | 51 · Multiple procedures | $1,737.80 | $1,819.70 | $3,311.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $724.44 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $691.83 | $724.44 | $1,318.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $489.78 Median $501.19 Typical High $933.25 | Professional | 81 · Minimal assistant surgeon | $489.78 | $501.19 | $933.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $489.78 Median $501.19 Typical High $933.25 | Professional | 82 · Assistant surgeon, no resident | $489.78 | $501.19 | $933.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $501.19 Typical High $933.25 | Professional | AS · PA/NP assist | $489.78 | $501.19 | $933.25 |
Where North Carolina sits
The same service costs 20.9 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· 18th of 51
$3,981
AK $11,220TX $537
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.