How much rates vary
Facilitymedian $3,162 · 10th to 90th $741 to $9,120Professionalmedian $2,754 · 10th to 90th $1,479 to $3,981
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 $1,288.25 Median $1,380.38 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,380.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,380.38 | $2,137.96 |
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 $1,905.46 Median $3,090.30 Typical High $3,981.07 | Professional | None | $1,905.46 | $3,090.30 | $3,981.07 |
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 $1,659.59 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,659.59 | $1,995.26 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $5,128.61 | Facility | None | $588.84 | $1,698.24 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,949.84 | $2,570.40 |
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 $1,380.38 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,778.28 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,174.90 |
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 $912.01 Median $977.24 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $912.01 | $977.24 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $389.05 Typical High $812.83 | Professional | 80 · Assistant surgeon | $371.54 | $389.05 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $275.42 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $257.04 | $275.42 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $275.42 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $275.42 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $275.42 Typical High $562.34 | Professional | AS · PA/NP assist | $257.04 | $275.42 | $562.34 |
Where North Carolina sits
The same service costs 5.8 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
$2,754
AK $5,623UT $977
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.