How much rates vary
Facilitymedian $1,950 · 10th to 90th $851 to $5,754Professionalmedian $1,413 · 10th to 90th $1,000 to $2,630
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 $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
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 $1,230.27 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,862.09 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,659.59 Typical High $2,187.76 | Facility | None | $645.65 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,318.26 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,148.15 Typical High $2,089.30 | Facility | None | $588.84 | $1,148.15 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
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 $912.01 Median $1,174.90 Typical High $2,290.87 | Professional | None | $912.01 | $1,174.90 | $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 $575.44 | Professional | 52 · Reduced service | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $812.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $575.44 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $295.12 | $575.44 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $691.83 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $616.60 | $691.83 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $275.42 Typical High $537.03 | Professional | 80 · Assistant surgeon | $245.47 | $275.42 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $190.55 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $169.82 | $190.55 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $190.55 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $190.55 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $190.55 Typical High $371.54 | Professional | AS · PA/NP assist | $169.82 | $190.55 | $371.54 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 16th of 51
$1,514
AK $3,715TX $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.