How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,570 · 10th to 90th $1,778 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 $1,737.80 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,737.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,737.80 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $3,162.28 Typical High $5,248.07 | Professional | None | $1,778.28 | $3,162.28 | $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 $2,570.40 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,570.40 | $4,786.30 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,737.80 | $2,089.30 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,089.30 | $2,818.38 |
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 $1,778.28 Median $2,511.89 Typical High $4,786.30 | Professional | None | $1,778.28 | $2,511.89 | $4,786.30 |
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 $870.96 Median $870.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 53 · Discontinued | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $1,174.90 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $831.76 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $467.74 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $331.13 | $467.74 | $1,023.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $323.59 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $229.09 | $323.59 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $323.59 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $323.59 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $323.59 Typical High $707.95 | Professional | AS · PA/NP assist | $229.09 | $323.59 | $707.95 |
Where North Carolina sits
The same service costs 5.8 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· 21st of 51
$2,455
AK $7,079TX $1,230
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.