How much rates vary
Facilitymedian $2,042 · 10th to 90th $741 to $6,026Professionalmedian $871 · 10th to 90th $372 to $1,585
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 $575.44 Median $1,288.25 Typical High $10,471.29 | Facility | None | $575.44 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $724.44 | Professional | None | $575.44 | $575.44 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,754.40 | Facility | None | $1,445.44 | $2,238.72 | $5,754.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $1,122.02 Typical High $1,621.81 | Professional | None | $371.54 | $1,122.02 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,388.44 | Facility | None | $794.33 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,548.82 | Professional | None | $645.65 | $831.76 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,511.89 | Facility | None | $707.95 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,071.52 | Professional | None | $691.83 | $794.33 | $1,071.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,445.44 | Professional | None | $575.44 | $741.31 | $1,445.44 |
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 $288.40 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $501.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $398.11 Typical High $851.14 | Professional | 51 · Multiple procedures | $371.54 | $398.11 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $158.49 Typical High $338.84 | Professional | 80 · Assistant surgeon | $147.91 | $158.49 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $112.20 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $102.33 | $112.20 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $112.20 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $112.20 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $112.20 Typical High $239.88 | Professional | AS · PA/NP assist | $102.33 | $112.20 | $239.88 |
Where North Carolina sits
The same service costs 5.4 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· 22nd of 51
$977
AK $2,399UT $447
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.