How much rates vary
Facilitymedian $2,570 · 10th to 90th $776 to $7,244Professionalmedian $1,585 · 10th to 90th $851 to $2,291
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 $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 $1,047.13 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,778.28 | $2,344.23 |
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 $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 $524.81 Median $1,445.44 Typical High $3,801.89 | Facility | None | $524.81 | $1,445.44 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $933.25 | $1,071.52 | $1,348.96 |
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 $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 $194.98 | Professional | 53 · Discontinued | $154.88 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $588.84 | $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 $549.54 Median $549.54 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $676.08 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $724.44 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $257.04 | $724.44 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $537.03 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $501.19 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $218.78 Typical High $457.09 | Professional | 80 · Assistant surgeon | $199.53 | $218.78 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $151.36 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $138.04 | $151.36 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $151.36 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $151.36 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $151.36 Typical High $316.23 | Professional | AS · PA/NP assist | $138.04 | $151.36 | $316.23 |
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· 8th of 51
$1,698
AK $3,311UT $575
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.