How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,380 to $12,882Professionalmedian $2,239 · 10th to 90th $1,622 to $4,266
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 $1,445.44 Median $1,698.24 Typical High $10,715.19 | Facility | None | $1,445.44 | $1,698.24 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,698.24 | $1,949.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,897.79 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,897.79 | $7,244.36 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,511.89 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,548.82 | $1,698.24 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,073.80 | Professional | None | $2,454.71 | $2,454.71 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $5,623.41 Typical High $13,803.84 | Facility | None | $1,905.46 | $5,623.41 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,819.70 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $4,168.69 | Professional | None | $1,412.54 | $1,778.28 | $4,168.69 |
11 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 $851.14 Median $851.14 Typical High $977.24 | Professional | 52 · Reduced service | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $891.25 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $870.96 | $891.25 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $363.08 Typical High $812.83 | Professional | 80 · Assistant surgeon | $346.74 | $363.08 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $251.19 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $239.88 | $251.19 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $251.19 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $251.19 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $251.19 Typical High $575.44 | Professional | AS · PA/NP assist | $239.88 | $251.19 | $575.44 |
Where North Carolina sits
The same service costs 11.2 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· 22nd of 51
$2,291
AK $7,244TX $646
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.