How much rates vary
Facilitymedian $2,692 · 10th to 90th $851 to $7,943Professionalmedian $1,230 · 10th to 90th $741 to $1,995
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 $1,584.89 Typical High $11,481.54 | Facility | None | $724.44 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,202.26 | Professional | None | $724.44 | $724.44 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,089.30 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $891.25 | $1,258.93 | $1,995.26 |
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 $794.33 Median $812.83 Typical High $1,819.70 | Professional | None | $794.33 | $812.83 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,174.90 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,202.26 | Professional | None | $851.14 | $870.96 | $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 $616.60 Median $794.33 Typical High $1,778.28 | Professional | None | $616.60 | $794.33 | $1,778.28 |
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 $416.87 | Professional | 52 · Reduced service | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $588.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $588.84 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $436.52 Typical High $870.96 | Professional | 51 · Multiple procedures | $426.58 | $436.52 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $173.78 Typical High $354.81 | Professional | 80 · Assistant surgeon | $169.82 | $173.78 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $120.23 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $120.23 | $120.23 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $120.23 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $120.23 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $120.23 Typical High $245.47 | Professional | AS · PA/NP assist | $120.23 | $120.23 | $245.47 |
Where North Carolina sits
The same service costs 8.5 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· 12th of 51
$1,230
AK $3,020TX $355
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.