How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $10,000Professionalmedian $2,291 · 10th to 90th $1,288 to $3,311
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 $1,318.26 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,318.26 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,398.83 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,621.81 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,265.80 | Facility | None | $831.76 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,445.44 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,479.11 | $3,235.94 |
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 $660.69 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,122.02 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $724.44 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $537.03 | $724.44 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $288.40 Typical High $741.31 | Professional | 80 · Assistant surgeon | $213.80 | $288.40 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $199.53 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $151.36 | $199.53 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $199.53 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $199.53 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $199.53 Typical High $512.86 | Professional | AS · PA/NP assist | $151.36 | $199.53 | $512.86 |
Where North Carolina sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 16th of 51
$2,399
AK $5,495UT $933
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.