How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,202 to $10,715Professionalmedian $1,950 · 10th to 90th $1,349 to $3,388
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 $1,288.25 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,288.25 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,288.25 | $1,445.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,265.80 Median $6,309.57 Typical High $8,511.38 | Facility | None | $4,265.80 | $6,309.57 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,454.71 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,677.35 Typical High $7,762.47 | Facility | None | $602.56 | $4,677.35 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,778.28 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $5,011.87 Typical High $10,471.29 | Facility | None | $1,288.25 | $5,011.87 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,698.24 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,819.70 | $3,162.28 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $851.14 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $812.83 | $851.14 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $338.84 Typical High $758.58 | Professional | 80 · Assistant surgeon | $323.59 | $338.84 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $234.42 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $223.87 | $234.42 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $234.42 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $234.42 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $234.42 Typical High $524.81 | Professional | AS · PA/NP assist | $223.87 | $234.42 | $524.81 |
Where North Carolina sits
The same service costs 6.9 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· 18th of 51
$2,089
AK $5,370TX $776
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.