How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,175 to $10,000Professionalmedian $1,259 · 10th to 90th $1,072 to $2,692
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 $1,148.15 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,148.15 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,148.15 | $1,698.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,258.93 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $4,168.69 Typical High $6,025.60 | Facility | None | $1,258.93 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,288.25 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,819.70 | $1,819.70 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $4,365.16 | Facility | None | $1,174.90 | $1,995.26 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,412.54 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,754.23 | Professional | None | $891.25 | $1,174.90 | $2,754.23 |
12 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 $575.44 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $870.96 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $831.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $588.84 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $562.34 | $707.95 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $281.84 Typical High $416.87 | Professional | 80 · Assistant surgeon | $223.87 | $281.84 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $199.53 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $154.88 | $199.53 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $199.53 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $199.53 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $199.53 Typical High $288.40 | Professional | AS · PA/NP assist | $154.88 | $199.53 | $288.40 |
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· 40th of 51
$1,380
AK $4,786TX $871
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.