How much rates vary
Facilitymedian $2,570 · 10th to 90th $724 to $6,918Professionalmedian $1,413 · 10th to 90th $776 to $2,042
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 $724.44 Median $1,047.13 Typical High $8,317.64 | Facility | None | $724.44 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,047.13 | Professional | None | $724.44 | $724.44 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $3,715.35 | Facility | None | $1,862.09 | $2,754.23 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,479.11 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,388.44 | Facility | None | $645.65 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,995.26 | Professional | None | $851.14 | $1,047.13 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $4,786.30 | Facility | None | $588.84 | $1,412.54 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,318.26 | Professional | None | $870.96 | $1,023.29 | $1,318.26 |
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 $707.95 Median $933.25 Typical High $1,819.70 | Professional | None | $707.95 | $933.25 | $1,819.70 |
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 $363.08 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $851.14 Typical High $2,398.83 | Facility | 51 · Multiple procedures | $295.12 | $851.14 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $512.86 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $489.78 | $512.86 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $204.17 Typical High $426.58 | Professional | 80 · Assistant surgeon | $194.98 | $204.17 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $144.54 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $138.04 | $144.54 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $144.54 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $144.54 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $144.54 Typical High $302.00 | Professional | AS · PA/NP assist | $138.04 | $144.54 | $302.00 |
Where North Carolina sits
The same service costs 7.9 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· 13th of 51
$1,479
OK $4,169UT $525
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.