How much rates vary
Facilitymedian $3,388 · 10th to 90th $646 to $8,318Professionalmedian $832 · 10th to 90th $100 to $1,479
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 $489.78 Median $1,288.25 Typical High $8,317.64 | Facility | None | $489.78 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
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 $100.00 Median $977.24 Typical High $1,479.11 | Professional | None | $100.00 | $977.24 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,073.80 Typical High $6,025.60 | Facility | None | $645.65 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $977.24 | Professional | None | $562.34 | $562.34 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,202.26 | Professional | None | $794.33 | $794.33 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $4,265.80 | Facility | None | $575.44 | $977.24 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $660.69 | Professional | None | $467.74 | $588.84 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | None | $549.54 | $549.54 | $575.44 |
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 $436.52 Median $549.54 Typical High $933.25 | Professional | None | $436.52 | $549.54 | $933.25 |
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 $239.88 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $407.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $295.12 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $309.03 Typical High $398.11 | Professional | 51 · Multiple procedures | $234.42 | $309.03 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $125.89 Typical High $158.49 | Professional | 80 · Assistant surgeon | $93.33 | $125.89 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $87.10 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $66.07 | $87.10 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $87.10 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $87.10 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $87.10 Typical High $109.65 | Professional | AS · PA/NP assist | $66.07 | $87.10 | $109.65 |
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
$851
AK $2,042TX $324
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.