How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $8,913Professionalmedian $2,754 · 10th to 90th $1,514 to $3,802
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 $1,380.38 Typical High $10,471.29 | Facility | None | $1,380.38 | $1,380.38 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,981.07 | $5,888.44 | $7,943.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $3,801.89 | Professional | None | $1,819.70 | $3,162.28 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,584.89 | $1,949.84 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,412.54 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,905.46 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,819.70 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $933.25 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $933.25 | $933.25 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $380.19 Typical High $794.33 | Professional | 80 · Assistant surgeon | $371.54 | $380.19 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $263.03 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $257.04 | $263.03 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $263.03 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $263.03 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $263.03 Typical High $549.54 | Professional | AS · PA/NP assist | $257.04 | $263.03 | $549.54 |
Where North Carolina sits
The same service costs 6.5 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
$2,884
AK $5,754TX $891
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.