How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,380 to $13,490Professionalmedian $2,692 · 10th to 90th $1,380 to $3,715
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 $1,380.38 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,380.38 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,380.38 | $2,187.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $12,022.64 | Facility | None | $4,677.35 | $7,762.47 | $12,022.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,691.53 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,760.83 Typical High $11,220.18 | Facility | None | $602.56 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,513.56 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,187.76 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $17,782.79 | Facility | None | $1,412.54 | $5,623.41 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,778.28 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,513.56 | $3,388.44 |
11 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 $776.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $891.25 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $851.14 | $891.25 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $354.81 Typical High $660.69 | Professional | 80 · Assistant surgeon | $346.74 | $354.81 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $245.47 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $239.88 | $245.47 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $245.47 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $245.47 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $245.47 Typical High $457.09 | Professional | AS · PA/NP assist | $239.88 | $245.47 | $457.09 |
Where North Carolina sits
The same service costs 18.6 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· 8th of 51
$2,692
AK $5,623TX $302
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.