How much rates vary
Facilitymedian $2,291 · 10th to 90th $912 to $5,888Professionalmedian $1,995 · 10th to 90th $1,349 to $3,631
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 $1,348.96 Median $1,348.96 Typical High $10,471.29 | Facility | None | $1,348.96 | $1,348.96 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
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 $1,548.82 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,548.82 | $2,137.96 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,479.11 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,137.96 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $3,019.95 | Facility | None | $741.31 | $1,348.96 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,513.56 | $2,238.72 |
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 $1,122.02 Median $1,445.44 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,445.44 | $3,311.31 |
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 $676.08 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,047.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $630.96 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $630.96 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $758.58 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $645.65 | $758.58 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $645.65 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $208.93 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $181.97 | $208.93 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $208.93 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $208.93 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $208.93 Typical High $457.09 | Professional | AS · PA/NP assist | $181.97 | $208.93 | $457.09 |
Where North Carolina sits
The same service costs 7.9 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
$1,995
AK $5,623TX $708
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.