How much rates vary
Facilitymedian $2,692 · 10th to 90th $851 to $7,244Professionalmedian $1,950 · 10th to 90th $1,047 to $2,818
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 $977.24 Median $1,288.25 Typical High $8,317.64 | Facility | None | $977.24 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
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 $1,348.96 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,344.23 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,412.54 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $4,466.84 | Facility | None | $588.84 | $1,698.24 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,412.54 | $1,905.46 |
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 $954.99 Median $1,258.93 Typical High $2,454.71 | Professional | None | $954.99 | $1,258.93 | $2,454.71 |
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 $489.78 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $851.14 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $295.12 | $851.14 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $691.83 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $660.69 | $691.83 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $281.84 Typical High $575.44 | Professional | 80 · Assistant surgeon | $263.03 | $281.84 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $194.98 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $186.21 | $194.98 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $194.98 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $194.98 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $194.98 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $194.98 | $407.38 |
Where North Carolina sits
The same service costs 5.6 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· 9th of 51
$2,042
AK $4,074UT $724
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.