How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,677Professionalmedian $1,148 · 10th to 90th $794 to $2,291
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 $776.25 Median $1,288.25 Typical High $10,471.29 | Facility | None | $776.25 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | None | $776.25 | $776.25 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,258.93 | $1,862.09 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,445.44 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $2,570.40 | Facility | None | $794.33 | $1,659.59 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,041.74 | Professional | None | $870.96 | $1,071.52 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,089.30 | Facility | None | $741.31 | $1,122.02 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,318.26 | Professional | None | $933.25 | $1,047.13 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,949.84 | Professional | None | $724.44 | $977.24 | $1,949.84 |
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 $389.05 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $691.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $562.34 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $363.08 | $562.34 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $524.81 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $467.74 | $524.81 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $457.09 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $323.59 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $323.59 |
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· 21st of 51
$1,202
AK $3,236UT $562
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.