How much rates vary
Facilitymedian $6,607 · 10th to 90th $776 to $32,359Professionalmedian $1,514 · 10th to 90th $851 to $2,344
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 $776.25 Median $1,148.15 Typical High $7,943.28 | Facility | None | $776.25 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | None | $776.25 | $776.25 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,162.28 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,162.28 | $4,677.35 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,905.46 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $23,442.29 Typical High $34,673.69 | Facility | None | $588.84 | $23,442.29 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,089.30 | Professional | None | $891.25 | $1,122.02 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,445.44 Typical High $26,915.35 | Facility | None | $549.54 | $1,445.44 | $26,915.35 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,288.25 | Professional | None | $794.33 | $1,096.48 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,232.93 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,232.93 | $26,302.68 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,949.84 | Professional | None | $776.25 | $1,000.00 | $1,949.84 |
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 $389.05 Median $389.05 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $676.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $3,467.37 Typical High $17,378.01 | Facility | 51 · Multiple procedures | $263.03 | $3,467.37 | $17,378.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $537.03 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $478.63 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $457.09 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $151.36 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $134.90 | $151.36 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $151.36 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $151.36 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $316.23 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $316.23 |
Where North Carolina sits
The same service costs 6.8 times more in Alaska than in Texas. 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· 11th of 51
$1,738
AK $3,715TX $550
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.