How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $10,471Professionalmedian $1,514 · 10th to 90th $1,047 to $2,951
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 $1,174.90 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,174.90 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,174.90 | $1,445.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $8,317.64 | Facility | None | $3,981.07 | $5,888.44 | $8,317.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,862.09 | $3,019.95 |
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 $954.99 Median $1,348.96 Typical High $2,818.38 | Professional | None | $954.99 | $1,348.96 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,230.27 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,258.93 | $1,949.84 |
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 $977.24 Median $1,318.26 Typical High $2,951.21 | Professional | None | $977.24 | $1,318.26 | $2,951.21 |
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 $588.84 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $630.96 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $630.96 | $630.96 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $251.19 Typical High $660.69 | Professional | 80 · Assistant surgeon | $251.19 | $251.19 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $177.83 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $173.78 | $177.83 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $177.83 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $177.83 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $177.83 Typical High $467.74 | Professional | AS · PA/NP assist | $173.78 | $177.83 | $467.74 |
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· 19th of 51
$1,698
AK $4,898TX $759
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.