How much rates vary
Facilitymedian $2,630 · 10th to 90th $813 to $7,079Professionalmedian $794 · 10th to 90th $575 to $1,413
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 $549.54 Median $1,445.44 Typical High $10,715.19 | Facility | None | $549.54 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | None | $549.54 | $549.54 | $616.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,019.95 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,412.54 | Professional | None | $602.56 | $1,023.29 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,162.28 Typical High $4,570.88 | Facility | None | $912.01 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,412.54 | Professional | None | $588.84 | $707.95 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $3,311.31 | Facility | None | $812.83 | $1,621.81 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $933.25 | Professional | None | $645.65 | $691.83 | $933.25 |
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 $537.03 Median $741.31 Typical High $1,412.54 | Professional | None | $537.03 | $741.31 | $1,412.54 |
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 $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $812.83 Typical High $1,659.59 | Facility | 51 · Multiple procedures | $416.87 | $812.83 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $346.74 Typical High $776.25 | Professional | 51 · Multiple procedures | $323.59 | $346.74 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $138.04 Typical High $309.03 | Professional | 80 · Assistant surgeon | $128.82 | $138.04 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $95.50 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $91.20 | $95.50 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $95.50 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $95.50 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $95.50 Typical High $213.80 | Professional | AS · PA/NP assist | $91.20 | $95.50 | $213.80 |
Where North Carolina sits
The same service costs 8.3 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· 21st of 51
$891
OK $2,951UT $355
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.