How much rates vary
Facilitymedian $2,188 · 10th to 90th $832 to $5,888Professionalmedian $1,288 · 10th to 90th $851 to $2,239
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 $831.76 Median $1,288.25 Typical High $8,317.64 | Facility | None | $831.76 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,548.82 | $2,290.87 | $3,090.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,412.54 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,905.46 | Professional | None | $933.25 | $977.24 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,380.38 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $3,235.94 | Facility | None | $602.56 | $1,258.93 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,380.38 | Professional | None | $831.76 | $954.99 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $2,041.74 | Professional | None | $676.08 | $891.25 | $2,041.74 |
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 $446.68 | Professional | 52 · Reduced service | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $630.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $630.96 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $630.96 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $478.63 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $416.87 | $478.63 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $190.55 Typical High $398.11 | Professional | 80 · Assistant surgeon | $169.82 | $190.55 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $134.90 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $120.23 | $134.90 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $134.90 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $134.90 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $134.90 Typical High $275.42 | Professional | AS · PA/NP assist | $120.23 | $134.90 | $275.42 |
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· 20th of 51
$1,288
AK $3,467TX $468
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.