How much rates vary
Facilitymedian $1,349 · 10th to 90th $447 to $3,890Professionalmedian $692 · 10th to 90th $372 to $1,349
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 $446.68 Median $1,000.00 Typical High $7,943.28 | Facility | None | $446.68 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | None | $446.68 | $446.68 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $812.83 Typical High $1,380.38 | Professional | None | $371.54 | $812.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $2,951.21 | Facility | None | $457.09 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $870.96 | Professional | None | $489.78 | $489.78 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,096.48 | Professional | None | $676.08 | $676.08 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $1,949.84 | Facility | None | $380.19 | $707.95 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $512.86 | Professional | None | $398.11 | $426.58 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $831.76 | Professional | None | $371.54 | $478.63 | $831.76 |
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 $223.87 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $354.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $354.81 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $186.21 | $354.81 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $213.80 Typical High $263.03 | Professional | 51 · Multiple procedures | $194.98 | $213.80 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $85.11 Typical High $107.15 | Professional | 80 · Assistant surgeon | $79.43 | $85.11 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $60.26 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $54.95 | $60.26 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $60.26 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $60.26 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $60.26 Typical High $74.13 | Professional | AS · PA/NP assist | $54.95 | $60.26 | $74.13 |
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· 15th of 51
$692
AK $1,862TX $302
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.