How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,175 to $9,120Professionalmedian $1,148 · 10th to 90th $776 to $1,950
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 $691.83 Median $1,584.89 Typical High $11,481.54 | Facility | None | $691.83 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,089.30 | Professional | None | $933.25 | $1,318.26 | $2,089.30 |
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 $794.33 Median $812.83 Typical High $1,380.38 | Professional | None | $794.33 | $812.83 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,202.26 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,096.48 | Professional | None | $660.69 | $851.14 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | None | $776.25 | $776.25 | $812.83 |
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 $602.56 Median $776.25 Typical High $1,348.96 | Professional | None | $602.56 | $776.25 | $1,348.96 |
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 $346.74 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $562.34 |
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 $331.13 Median $426.58 Typical High $588.84 | Professional | 51 · Multiple procedures | $331.13 | $426.58 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $173.78 Typical High $218.78 | Professional | 80 · Assistant surgeon | $131.83 | $173.78 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $93.33 | $120.23 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $120.23 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $154.88 |
Where North Carolina sits
The same service costs 6.3 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· 13th of 51
$1,148
AK $2,884TX $457
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.