How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,586Professionalmedian $3,311 · 10th to 90th $1,905 to $5,129
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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,698.24 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,570.40 | $3,890.45 | $5,248.07 |
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 $2,041.74 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,511.89 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $7,585.78 | Facility | None | $1,698.24 | $2,041.74 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,344.23 | $3,311.31 |
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 $1,737.80 Median $2,511.89 Typical High $4,677.35 | Professional | None | $1,737.80 | $2,511.89 | $4,677.35 |
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 $851.14 Median $851.14 Typical High $1,096.48 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $436.52 | Professional | 53 · Discontinued | $338.84 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,174.90 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $851.14 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $467.74 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $338.84 | $467.74 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $323.59 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $239.88 | $323.59 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $323.59 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $323.59 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $323.59 Typical High $691.83 | Professional | AS · PA/NP assist | $239.88 | $323.59 | $691.83 |
Where North Carolina sits
The same service costs 5.5 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· 12th of 51
$3,020
AK $6,918TX $1,259
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.