How much rates vary
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 $2,187.76 Typical High $10,964.78 | Facility | None | $1,584.89 | $2,187.76 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,187.76 | $2,511.89 |
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 $1,819.70 Median $3,801.89 Typical High $5,888.44 | Professional | None | $1,819.70 | $3,801.89 | $5,888.44 |
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 $1,862.09 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,862.09 | $2,137.96 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $5,248.07 | Professional | None | $3,019.95 | $3,019.95 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $10,000.00 Typical High $13,803.84 | Facility | None | $2,187.76 | $10,000.00 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,754.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $5,370.32 | Professional | None | $1,819.70 | $2,238.72 | $5,370.32 |
7 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 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,380.38 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $1,288.25 | $1,380.38 | $2,630.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $549.54 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $512.86 | $549.54 | $1,047.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $389.05 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $363.08 | $389.05 | $724.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $389.05 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $389.05 | $724.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $389.05 Typical High $724.44 | Professional | AS · PA/NP assist | $363.08 | $389.05 | $724.44 |
Where North Carolina sits
The same service costs 9.1 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· 18th of 51
$3,236
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.