How much rates vary
Facilitymedian $2,239 · 10th to 90th $724 to $7,413Professionalmedian $1,549 · 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 $794.33 Median $1,288.25 Typical High $8,317.64 | Facility | None | $794.33 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | None | $794.33 | $794.33 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,905.46 | $2,951.21 | $7,585.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,819.70 | $2,290.87 |
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 $954.99 Median $1,148.15 Typical High $2,137.96 | Professional | None | $954.99 | $1,148.15 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $3,548.13 | Facility | None | $602.56 | $1,513.56 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,380.38 | Professional | None | $954.99 | $1,122.02 | $1,380.38 |
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 $794.33 Median $1,023.29 Typical High $1,995.26 | Professional | None | $794.33 | $1,023.29 | $1,995.26 |
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 $398.11 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $851.14 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $295.12 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $562.34 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $537.03 | $562.34 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $223.87 Typical High $467.74 | Professional | 80 · Assistant surgeon | $213.80 | $223.87 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $158.49 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $151.36 | $158.49 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $158.49 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $158.49 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $158.49 Typical High $331.13 | Professional | AS · PA/NP assist | $151.36 | $158.49 | $331.13 |
Where North Carolina sits
The same service costs 6.6 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· 10th of 51
$1,660
OK $3,802UT $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.