How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,175 to $10,000Professionalmedian $1,122 · 10th to 90th $832 to $2,291
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 $831.76 Median $1,584.89 Typical High $11,481.54 | Facility | None | $831.76 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | None | $831.76 | $831.76 | $954.99 |
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 $933.25 Median $1,380.38 Typical High $2,398.83 | Professional | None | $933.25 | $1,380.38 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $5,248.07 Typical High $7,585.78 | Facility | None | $1,258.93 | $5,248.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $2,041.74 | Professional | None | $891.25 | $933.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,318.26 | $1,949.84 |
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 $1,000.00 Median $1,071.52 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,071.52 | $1,348.96 |
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 $707.95 Median $912.01 Typical High $2,041.74 | Professional | None | $707.95 | $912.01 | $2,041.74 |
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 $416.87 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $660.69 |
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 $512.86 Median $537.03 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $512.86 | $537.03 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $213.80 Typical High $398.11 | Professional | 80 · Assistant surgeon | $204.17 | $213.80 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $151.36 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $141.25 | $151.36 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $151.36 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $151.36 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $151.36 Typical High $281.84 | Professional | AS · PA/NP assist | $141.25 | $151.36 | $281.84 |
Where North Carolina sits
The same service costs 22.4 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· 23rd of 51
$1,202
AK $3,388TX $151
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.