How much rates vary
Facilitymedian $1,380 · 10th to 90th $575 to $3,890Professionalmedian $1,230 · 10th to 90th $851 to $2,455
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 $851.14 Median $1,288.25 Typical High $10,471.29 | Facility | None | $851.14 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | None | $851.14 | $851.14 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,819.70 | Facility | None | $912.01 | $1,380.38 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,380.38 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,454.71 Typical High $3,890.45 | Facility | None | $741.31 | $2,454.71 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $2,041.74 | Professional | None | $812.83 | $870.96 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,202.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,122.02 Typical High $3,388.44 | Facility | None | $724.44 | $1,122.02 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,412.54 | Professional | None | $831.76 | $1,023.29 | $1,412.54 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $2,089.30 | Professional | None | $707.95 | $912.01 | $2,089.30 |
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 $416.87 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $562.34 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $562.34 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $512.86 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $407.38 | $512.86 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $407.38 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $141.25 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $114.82 | $141.25 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $141.25 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $141.25 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $288.40 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $288.40 |
Where North Carolina sits
The same service costs 7.1 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· 20th of 51
$1,230
AK $3,548TX $501
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.