How much rates vary
Facilitymedian $3,802 · 10th to 90th $977 to $10,000Professionalmedian $1,318 · 10th to 90th $1,000 to $2,754
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 $977.24 Median $1,584.89 Typical High $11,481.54 | Facility | None | $977.24 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | None | $977.24 | $977.24 | $1,148.15 |
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 $1,122.02 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,659.59 | $2,884.03 |
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 $1,000.00 Median $1,071.52 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,071.52 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,479.11 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,000.00 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,174.90 | $1,698.24 |
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 $851.14 Median $1,096.48 Typical High $2,454.71 | Professional | None | $851.14 | $1,096.48 | $2,454.71 |
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 $489.78 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $741.31 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,778.28 Typical High $3,548.13 | Professional | 50 · Both sides | $1,659.59 | $1,778.28 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $588.84 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $549.54 | $588.84 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $234.42 Typical High $478.63 | Professional | 80 · Assistant surgeon | $218.78 | $234.42 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $165.96 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $154.88 | $165.96 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $165.96 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $165.96 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $165.96 Typical High $331.13 | Professional | AS · PA/NP assist | $154.88 | $165.96 | $331.13 |
Where North Carolina sits
The same service costs 18.2 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· 21st of 51
$1,445
AK $4,074TX $224
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.