How much rates vary
Facilitymedian $2,138 · 10th to 90th $832 to $7,244Professionalmedian $1,023 · 10th to 90th $550 to $1,549
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 $478.63 Median $1,445.44 Typical High $10,715.19 | Facility | None | $478.63 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | None | $478.63 | $478.63 | $630.96 |
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 $630.96 Median $1,023.29 Typical High $1,548.82 | Professional | None | $630.96 | $1,023.29 | $1,548.82 |
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 $575.44 Median $602.56 Typical High $1,258.93 | Professional | None | $575.44 | $602.56 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,949.84 Typical High $5,888.44 | Facility | None | $812.83 | $1,949.84 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,122.02 | Professional | None | $588.84 | $676.08 | $1,122.02 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $1,202.26 | Professional | None | $426.58 | $588.84 | $1,202.26 |
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 $239.88 Median $239.88 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $3,981.07 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $338.84 Typical High $616.60 | Professional | 51 · Multiple procedures | $295.12 | $338.84 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $138.04 Typical High $245.47 | Professional | 80 · Assistant surgeon | $120.23 | $138.04 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $95.50 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $83.18 | $95.50 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $95.50 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $95.50 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $95.50 Typical High $169.82 | Professional | AS · PA/NP assist | $83.18 | $95.50 | $169.82 |
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· 8th of 51
$1,023
AK $1,995TX $110
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.