How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,585 to $9,120Professionalmedian $2,951 · 10th to 90th $1,585 to $4,365
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 $1,584.89 Median $1,698.24 Typical High $11,481.54 | Facility | None | $1,584.89 | $1,698.24 | $11,481.54 |
Aetna 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 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $4,897.79 | Professional | None | $1,905.46 | $3,235.94 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,011.87 Typical High $6,025.60 | Facility | None | $1,698.24 | $5,011.87 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,041.74 | $3,981.07 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $5,370.32 | Facility | None | $1,548.82 | $2,344.23 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,862.09 | $2,570.40 |
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 $1,479.11 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,949.84 | $3,890.45 |
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 $794.33 Median $794.33 Typical High $954.99 | Professional | 52 · Reduced service | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,348.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,174.90 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $776.25 | $1,174.90 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $933.25 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $831.76 | $933.25 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $371.54 Typical High $891.25 | Professional | 80 · Assistant surgeon | $331.13 | $371.54 | $891.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $263.03 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $234.42 | $263.03 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $263.03 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $263.03 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $263.03 Typical High $630.96 | Professional | AS · PA/NP assist | $234.42 | $263.03 | $630.96 |
Where North Carolina sits
The same service costs 6.3 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· 11th of 51
$3,020
AK $6,457UT $1,023
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.