How much rates vary
Facilitymedian $1,202 · 10th to 90th $550 to $2,754Professionalmedian $933 · 10th to 90th $525 to $1,660
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 $616.60 Median $1,148.15 Typical High $7,943.28 | Facility | None | $616.60 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,737.80 | Professional | None | $645.65 | $933.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,819.70 | Facility | None | $602.56 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,380.38 | Professional | None | $501.19 | $549.54 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,445.44 | Professional | None | $741.31 | $741.31 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $1,905.46 | Facility | None | $524.81 | $812.83 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,023.29 | Professional | None | $537.03 | $691.83 | $1,023.29 |
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 $478.63 Median $616.60 Typical High $1,548.82 | Professional | None | $478.63 | $616.60 | $1,548.82 |
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 $309.03 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $501.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $426.58 Typical High $933.25 | Facility | 51 · Multiple procedures | $257.04 | $426.58 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $346.74 Typical High $758.58 | Professional | 51 · Multiple procedures | $269.15 | $346.74 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $302.00 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $97.72 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $74.13 | $97.72 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $97.72 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $97.72 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $97.72 Typical High $213.80 | Professional | AS · PA/NP assist | $74.13 | $97.72 | $213.80 |
Where North Carolina sits
The same service costs 7.4 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· 17th of 51
$933
AK $2,570TX $347
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.