How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,445 to $3,548
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 $1,288.25 Median $1,445.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,445.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,570.40 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,905.46 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $5,370.32 | Facility | None | $1,445.44 | $1,737.80 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,862.09 | $2,344.23 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,698.24 | $3,548.13 |
11 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 $724.44 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $933.25 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $831.76 | $933.25 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $371.54 Typical High $831.76 | Professional | 80 · Assistant surgeon | $331.13 | $371.54 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $257.04 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $234.42 | $257.04 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $257.04 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $257.04 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $257.04 Typical High $588.84 | Professional | AS · PA/NP assist | $234.42 | $257.04 | $588.84 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 14th of 51
$2,291
AK $6,026UT $1,072
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.