How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,585 to $24,547Professionalmedian $2,884 · 10th to 90th $1,622 to $4,467
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 $1,288.25 Median $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,584.89 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12,302.69 Median $17,782.79 Typical High $24,547.09 | Facility | None | $12,302.69 | $17,782.79 | $24,547.09 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,884.03 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,182.57 Typical High $21,877.62 | Facility | None | $602.56 | $13,182.57 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $3,981.07 | Professional | None | $1,737.80 | $1,819.70 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,715.35 | Professional | None | $2,630.27 | $2,630.27 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $6,606.93 Typical High $34,673.69 | Facility | None | $1,621.81 | $6,606.93 | $34,673.69 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,949.84 | $1,995.26 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,737.80 | $3,890.45 |
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 $794.33 Median $794.33 Typical High $912.01 | Professional | 52 · Reduced service | $794.33 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $363.08 | Professional | 53 · Discontinued | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,000.00 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $977.24 | $1,000.00 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $398.11 Typical High $758.58 | Professional | 80 · Assistant surgeon | $398.11 | $398.11 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $281.84 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $275.42 | $281.84 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $281.84 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $281.84 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $281.84 Typical High $537.03 | Professional | AS · PA/NP assist | $275.42 | $281.84 | $537.03 |
Where North Carolina sits
The same service costs 20.4 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· 11th of 51
$2,884
AK $6,607TX $324
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.