How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $4,169 · 10th to 90th $2,399 to $6,310
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 $2,187.76 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,187.76 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,187.76 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,311.31 Median $4,265.80 Typical High $6,760.83 | Professional | None | $3,311.31 | $4,265.80 | $6,760.83 |
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 $2,630.27 Median $3,235.94 Typical High $6,025.60 | Professional | None | $2,630.27 | $3,235.94 | $6,025.60 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $9,772.37 | Facility | None | $2,187.76 | $2,630.27 | $9,772.37 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,951.21 | $3,801.89 |
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 $2,238.72 Median $3,235.94 Typical High $6,025.60 | Professional | None | $2,238.72 | $3,235.94 | $6,025.60 |
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 $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 53 · Discontinued | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,479.11 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $1,047.13 | $1,479.11 | $3,235.94 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $588.84 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $416.87 | $588.84 | $1,288.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $416.87 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $295.12 | $416.87 | $912.01 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $416.87 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $416.87 | $912.01 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $416.87 Typical High $912.01 | Professional | AS · PA/NP assist | $295.12 | $416.87 | $912.01 |
Where North Carolina sits
The same service costs 6.2 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
$3,802
AK $9,120TX $1,479
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.