How much rates vary
Facilitymedian $2,344 · 10th to 90th $851 to $6,026Professionalmedian $1,778 · 10th to 90th $977 to $2,570
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 $912.01 Median $1,288.25 Typical High $8,317.64 | Facility | None | $912.01 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,445.44 | Professional | None | $912.01 | $912.01 | $1,445.44 |
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 $1,258.93 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,949.84 | $2,570.40 |
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 $1,071.52 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,318.26 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,511.89 | Facility | None | $602.56 | $1,148.15 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,258.93 | $1,737.80 |
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 $891.25 Median $1,148.15 Typical High $2,290.87 | Professional | None | $891.25 | $1,148.15 | $2,290.87 |
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 $457.09 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $776.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $575.44 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $295.12 | $575.44 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $630.96 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $602.56 | $630.96 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $251.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $251.19 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $177.83 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $169.82 | $177.83 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $177.83 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $177.83 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $177.83 Typical High $380.19 | Professional | AS · PA/NP assist | $169.82 | $177.83 | $380.19 |
Where North Carolina sits
The same service costs 6.2 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
$1,862
OK $4,074UT $661
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.