How much rates vary
Facilitymedian $3,388 · 10th to 90th $741 to $7,586Professionalmedian $977 · 10th to 90th $617 to $1,549
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 $616.60 Median $616.60 Typical High $5,248.07 | Facility | None | $616.60 | $616.60 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | None | $616.60 | $616.60 | $691.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $6,309.57 | Facility | None | $3,019.95 | $4,466.84 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $776.25 | $1,122.02 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $5,495.41 | Facility | None | $602.56 | $3,311.31 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,584.89 | Professional | None | $645.65 | $794.33 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $6,918.31 | Facility | None | $616.60 | $3,311.31 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,122.02 | Professional | None | $724.44 | $758.58 | $1,122.02 |
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 $588.84 Median $812.83 Typical High $1,513.56 | Professional | None | $588.84 | $812.83 | $1,513.56 |
11 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 $309.03 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $478.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $380.19 Typical High $870.96 | Professional | 51 · Multiple procedures | $354.81 | $380.19 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $151.36 Typical High $346.74 | Professional | 80 · Assistant surgeon | $144.54 | $151.36 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $107.15 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $100.00 | $107.15 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $107.15 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $107.15 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $107.15 Typical High $245.47 | Professional | AS · PA/NP assist | $100.00 | $107.15 | $245.47 |
Where North Carolina sits
The same service costs 6.2 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· 19th of 51
$1,000
AK $2,512UT $407
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.