How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $10,000Professionalmedian $2,138 · 10th to 90th $1,175 to $2,951
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 $1,047.13 Median $1,288.25 Typical High $10,715.19 | Facility | None | $1,047.13 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
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 $1,380.38 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,344.23 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,202.26 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,778.28 | $1,778.28 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $5,888.44 | Facility | None | $831.76 | $1,995.26 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,258.93 | $1,380.38 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,096.48 | $1,148.15 |
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 $933.25 Median $1,174.90 Typical High $2,041.74 | Professional | None | $933.25 | $1,174.90 | $2,041.74 |
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 $524.81 Median $524.81 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $870.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $3,388.44 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $630.96 Typical High $794.33 | Professional | 51 · Multiple procedures | $501.19 | $630.96 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $263.03 Typical High $323.59 | Professional | 80 · Assistant surgeon | $204.17 | $263.03 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $141.25 | $186.21 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $186.21 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $186.21 Typical High $223.87 | Professional | AS · PA/NP assist | $141.25 | $186.21 | $223.87 |
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· 8th of 51
$2,138
AK $4,365TX $708
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.