How much rates vary
Facilitymedian $2,570 · 10th to 90th $794 to $7,244Professionalmedian $1,698 · 10th to 90th $1,122 to $3,090
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 $1,122.02 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,122.02 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,122.02 | $2,187.76 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $5,370.32 | Facility | None | $602.56 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,621.81 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,445.44 Typical High $3,801.89 | Facility | None | $549.54 | $1,445.44 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,584.89 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,445.44 | $2,818.38 |
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 $562.34 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $977.24 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $724.44 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $263.03 | $724.44 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $794.33 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $676.08 | $794.33 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $316.23 Typical High $660.69 | Professional | 80 · Assistant surgeon | $269.15 | $316.23 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $218.78 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $186.21 | $218.78 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $218.78 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $218.78 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $467.74 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $467.74 |
Where North Carolina sits
The same service costs 5.8 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· 21st of 51
$1,778
AK $4,677UT $813
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.