How much rates vary
Facilitymedian $1,259 · 10th to 90th $617 to $3,890Professionalmedian $1,047 · 10th to 90th $692 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 $630.96 Median $776.25 Typical High $10,964.78 | Facility | None | $630.96 | $776.25 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $831.76 | Professional | None | $630.96 | $776.25 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $2,041.74 | Professional | None | $812.83 | $1,288.25 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $3,890.45 | Facility | None | $660.69 | $1,174.90 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,737.80 | Professional | None | $691.83 | $831.76 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,148.15 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,905.46 | Facility | None | $794.33 | $1,174.90 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,318.26 | Professional | None | $831.76 | $977.24 | $1,318.26 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,737.80 | Professional | None | $562.34 | $794.33 | $1,737.80 |
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 $309.03 Median $389.05 Typical High $407.38 | Professional | 52 · Reduced service | $309.03 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $125.89 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $81.28 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $575.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $436.52 Median $588.84 Typical High $954.99 | Facility | 51 · Multiple procedures | $436.52 | $588.84 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $489.78 Typical High $954.99 | Professional | 51 · Multiple procedures | $416.87 | $489.78 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $380.19 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $134.90 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $114.82 | $134.90 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $134.90 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $134.90 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $263.03 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $263.03 |
Where North Carolina sits
The same service costs 5.6 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
$1,072
AK $2,630TX $468
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.