How much rates vary
Facilitymedian $2,512 · 10th to 90th $759 to $8,318Professionalmedian $1,445 · 10th to 90th $1,000 to $2,692
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 $954.99 Median $1,047.13 Typical High $8,317.64 | Facility | None | $954.99 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,445.44 | Professional | None | $954.99 | $954.99 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,288.25 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,819.70 | $2,691.53 |
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 $1,096.48 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,348.96 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $4,786.30 | Facility | None | $602.56 | $1,698.24 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,348.96 | $1,862.09 |
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 $912.01 Median $1,202.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,202.26 | $2,344.23 |
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 $467.74 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $812.83 |
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 $630.96 Median $660.69 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $630.96 | $660.69 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $269.15 Typical High $549.54 | Professional | 80 · Assistant surgeon | $257.04 | $269.15 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $186.21 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $177.83 | $186.21 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $186.21 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $186.21 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $186.21 Typical High $389.05 | Professional | AS · PA/NP assist | $177.83 | $186.21 | $389.05 |
Where North Carolina sits
The same service costs 5.9 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· 21st of 51
$1,549
OK $4,074UT $692
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.