How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $6,026 · 10th to 90th $3,162 to $8,913
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 $1,288.25 Median $3,162.28 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,073.80 | Professional | None | $3,162.28 | $3,162.28 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4,570.88 Median $7,585.78 Typical High $9,549.93 | Professional | None | $4,570.88 | $7,585.78 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $8,709.64 | Professional | None | $3,019.95 | $4,570.88 | $8,709.64 |
Medcost Setting Facility Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $10,232.93 | Facility | None | $3,162.28 | $3,801.89 | $10,232.93 |
Medcost Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,162.28 | $3,890.45 | $5,128.61 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $8,511.38 | Professional | None | $3,235.94 | $4,570.88 | $8,511.38 |
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 $1,548.82 Median $1,548.82 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 53 · Discontinued | $630.96 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,818.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,548.82 Median $2,137.96 Typical High $4,570.88 | Professional | 51 · Multiple procedures | $1,548.82 | $2,137.96 | $4,570.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $630.96 Median $851.14 Typical High $1,819.70 | Professional | 80 · Assistant surgeon | $630.96 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $436.52 Median $602.56 Typical High $1,288.25 | Professional | 81 · Minimal assistant surgeon | $436.52 | $602.56 | $1,288.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $436.52 Median $602.56 Typical High $1,288.25 | Professional | 82 · Assistant surgeon, no resident | $436.52 | $602.56 | $1,288.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $602.56 Typical High $1,288.25 | Professional | AS · PA/NP assist | $436.52 | $602.56 | $1,288.25 |
Where North Carolina sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 14th of 51
$5,129
AK $12,589AR $1,995
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.