How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,622 to $24,547Professionalmedian $4,898 · 10th to 90th $2,512 to $6,918
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 $2,398.83 Typical High $10,964.78 | Facility | None | $1,584.89 | $2,398.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,398.83 | $3,090.30 |
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 $3,090.30 Median $6,025.60 Typical High $7,244.36 | Professional | None | $3,090.30 | $6,025.60 | $7,244.36 |
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 $2,691.53 Median $2,818.38 Typical High $6,165.95 | Professional | None | $2,691.53 | $2,818.38 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,754.40 | Professional | None | $4,265.80 | $4,265.80 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $9,332.54 Typical High $34,673.69 | Facility | None | $2,454.71 | $9,332.54 | $34,673.69 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,235.94 | $3,981.07 |
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 $2,089.30 Median $2,754.23 Typical High $6,025.60 | Professional | None | $2,089.30 | $2,754.23 | $6,025.60 |
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 $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 53 · Discontinued | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,621.81 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,445.44 | $1,621.81 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $660.69 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $575.44 | $660.69 | $1,174.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $398.11 | $457.09 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $457.09 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | AS · PA/NP assist | $398.11 | $457.09 | $812.83 |
Where North Carolina sits
The same service costs 25.7 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
$5,012
AK $10,000TX $389
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.