How much rates vary
Facilitymedian $2,512 · 10th to 90th $794 to $8,511Professionalmedian $1,175 · 10th to 90th $631 to $1,862
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 $794.33 Typical High $8,511.38 | Facility | None | $630.96 | $794.33 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,023.29 | Professional | None | $630.96 | $794.33 | $1,023.29 |
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 $758.58 Median $1,174.90 Typical High $1,949.84 | Professional | None | $758.58 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,659.59 | Professional | None | $616.60 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,862.09 | Professional | None | $954.99 | $954.99 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,096.48 Typical High $5,495.41 | Facility | None | $724.44 | $1,096.48 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,258.93 | Professional | None | $602.56 | $891.25 | $1,258.93 |
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 $758.58 Typical High $1,698.24 | Professional | None | $562.34 | $758.58 | $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 $316.23 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $562.34 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $446.68 Typical High $912.01 | Professional | 51 · Multiple procedures | $302.00 | $446.68 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $181.97 Typical High $363.08 | Professional | 80 · Assistant surgeon | $120.23 | $181.97 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $125.89 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $85.11 | $125.89 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $125.89 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $125.89 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $125.89 Typical High $251.19 | Professional | AS · PA/NP assist | $85.11 | $125.89 | $251.19 |
Where North Carolina sits
The same service costs 6.6 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· 11th of 51
$1,175
AK $3,020TX $457
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.