How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $6,457Professionalmedian $1,202 · 10th to 90th $676 to $1,820
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 $616.60 Median $1,288.25 Typical High $8,317.64 | Facility | None | $616.60 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | None | $616.60 | $616.60 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,122.02 | $1,659.59 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,862.09 | Professional | None | $831.76 | $1,258.93 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,659.59 | Professional | None | $691.83 | $870.96 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $3,801.89 | Facility | None | $588.84 | $977.24 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $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 $616.60 Median $794.33 Typical High $1,548.82 | Professional | None | $616.60 | $794.33 | $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 $309.03 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $537.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $436.52 Typical High $912.01 | Professional | 51 · Multiple procedures | $389.05 | $436.52 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $173.78 Typical High $363.08 | Professional | 80 · Assistant surgeon | $158.49 | $173.78 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $120.23 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $109.65 | $120.23 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $120.23 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $120.23 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $120.23 Typical High $251.19 | Professional | AS · PA/NP assist | $109.65 | $120.23 | $251.19 |
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· 15th of 51
$1,202
AK $2,570UT $479
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.