How much rates vary
Facilitymedian $1,318 · 10th to 90th $479 to $3,890Professionalmedian $245 · 10th to 90th $178 to $490
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 $177.83 Median $1,148.15 Typical High $7,943.28 | Facility | None | $177.83 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $208.93 | Professional | None | $169.82 | $177.83 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $2,754.23 | Facility | None | $691.83 | $1,096.48 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $501.19 | Professional | None | $181.97 | $316.23 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,951.21 | Facility | None | $602.56 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $436.52 | Professional | None | $186.21 | $229.09 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $691.83 Typical High $1,778.28 | Facility | None | $302.00 | $691.83 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $295.12 | Professional | None | $194.98 | $223.87 | $295.12 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $446.68 | Professional | None | $165.96 | $234.42 | $446.68 |
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 $89.13 Median $89.13 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $141.25 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $223.87 Median $346.74 Typical High $891.25 | Facility | 51 · Multiple procedures | $223.87 | $346.74 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $112.20 Typical High $251.19 | Professional | 51 · Multiple procedures | $107.15 | $112.20 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $44.67 Typical High $100.00 | Professional | 80 · Assistant surgeon | $42.66 | $44.67 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $31.62 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $30.20 | $31.62 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $31.62 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $31.62 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $31.62 Typical High $70.79 | Professional | AS · PA/NP assist | $30.20 | $31.62 | $70.79 |
Where North Carolina sits
The same service costs 8.7 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· 19th of 51
$295
OK $1,349UT $155
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.