How much rates vary
Facilitymedian $3,388 · 10th to 90th $813 to $10,000Professionalmedian $1,380 · 10th to 90th $832 to $2,399
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 $812.83 Median $1,288.25 Typical High $10,471.29 | Facility | None | $812.83 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $831.76 Median $1,621.81 Typical High $2,454.71 | Professional | None | $831.76 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $1,621.81 | Professional | None | $954.99 | $977.24 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,412.54 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $4,265.80 | Facility | None | $741.31 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,148.15 | Professional | None | $776.25 | $1,047.13 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | None | $891.25 | $891.25 | $954.99 |
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 $724.44 Median $933.25 Typical High $1,548.82 | Professional | None | $724.44 | $933.25 | $1,548.82 |
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 $398.11 Median $398.11 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $524.81 Typical High $630.96 | Professional | 51 · Multiple procedures | $389.05 | $524.81 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $208.93 Typical High $251.19 | Professional | 80 · Assistant surgeon | $154.88 | $208.93 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $109.65 | $144.54 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $144.54 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | AS · PA/NP assist | $109.65 | $144.54 | $177.83 |
Where North Carolina sits
The same service costs 6.5 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· 13th of 51
$1,380
AK $3,311TX $513
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.