How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,202 to $10,965Professionalmedian $2,818 · 10th to 90th $1,413 to $3,981
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 $1,412.54 Median $1,412.54 Typical High $10,471.29 | Facility | None | $1,412.54 | $1,412.54 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,370.32 Typical High $7,244.36 | Facility | None | $3,548.13 | $5,370.32 | $7,244.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $3,019.95 Typical High $4,073.80 | Professional | None | $1,698.24 | $3,019.95 | $4,073.80 |
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 $1,548.82 Median $1,584.89 Typical High $3,467.37 | Professional | None | $1,548.82 | $1,584.89 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,238.72 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $3,311.31 Typical High $10,471.29 | Facility | None | $1,445.44 | $3,311.31 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,737.80 | $2,290.87 |
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 $1,202.26 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,548.82 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $870.96 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $794.33 | $870.96 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $354.81 Typical High $676.08 | Professional | 80 · Assistant surgeon | $316.23 | $354.81 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $245.47 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $223.87 | $245.47 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $245.47 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $245.47 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $245.47 Typical High $467.74 | Professional | AS · PA/NP assist | $223.87 | $245.47 | $467.74 |
Where North Carolina sits
The same service costs 19.5 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
$2,818
AK $5,754TX $295
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.