How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $10,000Professionalmedian $1,698 · 10th to 90th $191 to $3,090
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 $1,258.93 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,258.93 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
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 $190.55 Median $2,187.76 Typical High $3,311.31 | Professional | None | $190.55 | $2,187.76 | $3,311.31 |
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 $1,258.93 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,621.81 | $3,162.28 |
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 $1,380.38 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,479.11 | $2,089.30 |
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 $1,174.90 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,479.11 | $3,090.30 |
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 $630.96 Median $630.96 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,071.52 |
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 $691.83 Median $741.31 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $691.83 | $741.31 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $302.00 Typical High $707.95 | Professional | 80 · Assistant surgeon | $275.42 | $302.00 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $208.93 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $190.55 | $208.93 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $208.93 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $208.93 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $208.93 Typical High $501.19 | Professional | AS · PA/NP assist | $190.55 | $208.93 | $501.19 |
Where North Carolina sits
The same service costs 6.6 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· 26th of 51
$1,820
AK $5,248TX $794
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.