How much rates vary
Facilitymedian $955 · 10th to 90th $380 to $7,244Professionalmedian $1,660 · 10th to 90th $977 to $2,884
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 $954.99 Median $954.99 Typical High $7,943.28 | Facility | None | $954.99 | $954.99 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,380.38 | $2,238.72 | $3,019.95 |
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 $1,202.26 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,412.54 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $1,513.56 | Facility | None | $933.25 | $954.99 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,548.82 | Professional | None | $891.25 | $1,258.93 | $1,548.82 |
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 $977.24 Median $1,548.82 Typical High $2,570.40 | Professional | None | $977.24 | $1,548.82 | $2,570.40 |
10 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 $478.63 Median $478.63 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $120.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $630.96 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $446.68 | $630.96 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $251.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $181.97 | $251.19 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $173.78 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $125.89 | $173.78 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $173.78 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $173.78 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $173.78 Typical High $363.08 | Professional | AS · PA/NP assist | $125.89 | $173.78 | $363.08 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 13th of 51
$1,622
AK $3,890KY $832
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.