How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,622 to $24,547Professionalmedian $4,169 · 10th to 90th $2,239 to $6,026
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 $1,584.89 Median $2,089.30 Typical High $10,964.78 | Facility | None | $1,584.89 | $2,089.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | None | $2,089.30 | $2,089.30 | $2,454.71 |
BCBS North Carolina Setting Facility Modifier None Typical Low $9,332.54 Median $15,135.61 Typical High $23,442.29 | Facility | None | $9,332.54 | $15,135.61 | $23,442.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,691.53 Median $4,570.88 Typical High $6,309.57 | Professional | None | $2,691.53 | $4,570.88 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,182.57 Typical High $21,877.62 | Facility | None | $602.56 | $13,182.57 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $5,370.32 | Professional | None | $2,398.83 | $2,454.71 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,897.79 | Professional | None | $3,715.35 | $3,715.35 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $8,709.64 Typical High $34,673.69 | Facility | None | $2,137.96 | $8,709.64 | $34,673.69 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,570.40 | $2,691.53 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $5,128.61 | Professional | None | $1,819.70 | $2,398.83 | $5,128.61 |
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 $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,348.96 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,288.25 | $1,348.96 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $537.03 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $512.86 | $537.03 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $380.19 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $363.08 | $380.19 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $380.19 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $380.19 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $380.19 Typical High $707.95 | Professional | AS · PA/NP assist | $363.08 | $380.19 | $707.95 |
Where North Carolina sits
The same service costs 6.5 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· 6th of 51
$4,365
AK $8,710TX $1,349
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.