How much rates vary
Facilitymedian $1,445 · 10th to 90th $603 to $3,890Professionalmedian $1,905 · 10th to 90th $1,023 to $2,818
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 $1,023.29 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,023.29 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
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 $1,288.25 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,905.46 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,691.53 Typical High $3,235.94 | Facility | None | $912.01 | $2,691.53 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,096.48 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,584.89 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,398.83 | Facility | None | $758.58 | $1,023.29 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,698.24 | Professional | None | $977.24 | $1,174.90 | $1,698.24 |
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 $870.96 Median $1,096.48 Typical High $2,570.40 | Professional | None | $870.96 | $1,096.48 | $2,570.40 |
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 $512.86 Median $512.86 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $478.63 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $478.63 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $588.84 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $489.78 | $588.84 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $501.19 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $165.96 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $138.04 | $165.96 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $165.96 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $165.96 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $346.74 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $346.74 |
Where North Carolina sits
The same service costs 7.6 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· 10th of 51
$1,905
AK $4,266TX $562
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.