How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $10,000Professionalmedian $2,455 · 10th to 90th $1,259 to $5,370
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 $1,202.26 Median $1,380.38 Typical High $10,715.19 | Facility | None | $1,202.26 | $1,380.38 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,202.26 | $1,445.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,801.89 Typical High $6,165.95 | Facility | None | $2,398.83 | $3,801.89 | $6,165.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $3,019.95 Typical High $5,370.32 | Professional | None | $1,479.11 | $3,019.95 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,412.54 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,041.74 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,258.93 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,548.82 | $1,995.26 |
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 $1,047.13 Median $1,348.96 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,348.96 | $3,019.95 |
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 $602.56 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $758.58 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $691.83 | $758.58 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $309.03 Typical High $588.84 | Professional | 80 · Assistant surgeon | $275.42 | $309.03 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $213.80 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $190.55 | $213.80 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $213.80 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $213.80 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $213.80 Typical High $407.38 | Professional | AS · PA/NP assist | $190.55 | $213.80 | $407.38 |
Where North Carolina sits
The same service costs 14.5 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· 8th of 51
$2,455
AK $4,898TX $339
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.