How much rates vary
Facilitymedian $3,388 · 10th to 90th $832 to $8,318Professionalmedian $1,072 · 10th to 90th $676 to $2,042
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 $602.56 Median $794.33 Typical High $10,000.00 | Facility | None | $602.56 | $794.33 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $933.25 | Professional | None | $602.56 | $794.33 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,089.30 | Professional | None | $776.25 | $1,258.93 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,698.24 | Professional | None | $676.08 | $831.76 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,122.02 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,380.38 Typical High $4,265.80 | Facility | None | $812.83 | $1,380.38 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,288.25 | Professional | None | $707.95 | $1,023.29 | $1,288.25 |
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 $562.34 Median $794.33 Typical High $1,698.24 | Professional | None | $562.34 | $794.33 | $1,698.24 |
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 $302.00 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $457.09 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $575.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $512.86 Typical High $933.25 | Professional | 51 · Multiple procedures | $354.81 | $512.86 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $204.17 Typical High $371.54 | Professional | 80 · Assistant surgeon | $141.25 | $204.17 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $141.25 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $100.00 | $141.25 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $141.25 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $141.25 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $141.25 Typical High $257.04 | Professional | AS · PA/NP assist | $100.00 | $141.25 | $257.04 |
Where North Carolina sits
The same service costs 6.2 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· 13th of 51
$1,096
AK $3,020TX $490
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.