How much rates vary
Facilitymedian $3,548 · 10th to 90th $603 to $9,550Professionalmedian $891 · 10th to 90th $550 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 $1,445.44 Typical High $10,715.19 | Facility | None | $575.44 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | None | $575.44 | $575.44 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $6,025.60 | Facility | None | $3,019.95 | $4,466.84 | $6,025.60 |
BCBS North Carolina Setting Professional Modifier None Typical Low $549.54 Median $1,122.02 Typical High $1,584.89 | Professional | None | $549.54 | $1,122.02 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $5,495.41 | Facility | None | $602.56 | $3,311.31 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,548.82 | Professional | None | $660.69 | $812.83 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $575.44 Typical High $5,011.87 | Facility | None | $102.33 | $575.44 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,258.93 | Professional | None | $645.65 | $912.01 | $1,258.93 |
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 $575.44 Median $724.44 Typical High $1,412.54 | Professional | None | $575.44 | $724.44 | $1,412.54 |
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 $281.84 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $457.09 Typical High $831.76 | Professional | 51 · Multiple procedures | $380.19 | $457.09 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $331.13 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $234.42 |
Where North Carolina sits
The same service costs 9.8 times more in Oklahoma 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· 23rd of 51
$977
OK $4,365UT $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.