How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,202 to $11,749Professionalmedian $3,162 · 10th to 90th $2,089 to $6,310
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 $2,238.72 Typical High $10,471.29 | Facility | None | $1,584.89 | $2,238.72 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,630.27 | Professional | None | $2,238.72 | $2,238.72 | $2,630.27 |
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 $2,089.30 Median $3,981.07 Typical High $6,760.83 | Professional | None | $2,089.30 | $3,981.07 | $6,760.83 |
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 $2,511.89 Median $2,630.27 Typical High $5,754.40 | Professional | None | $2,511.89 | $2,630.27 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,248.07 | Professional | None | $3,890.45 | $3,890.45 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $2,238.72 Median $9,120.11 Typical High $14,454.40 | Facility | None | $2,238.72 | $9,120.11 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,715.35 | Professional | None | $2,754.23 | $2,884.03 | $3,715.35 |
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 $1,949.84 Median $2,570.40 Typical High $5,495.41 | Professional | None | $1,949.84 | $2,570.40 | $5,495.41 |
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 $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 53 · Discontinued | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,445.44 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $1,445.44 | $1,445.44 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $575.44 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $575.44 | $575.44 | $1,071.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $407.38 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $398.11 | $407.38 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $407.38 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $407.38 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $407.38 Typical High $758.58 | Professional | AS · PA/NP assist | $398.11 | $407.38 | $758.58 |
Where North Carolina sits
The same service costs 21.9 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· 19th of 51
$3,311
AK $9,333TX $427
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.