How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $8,318Professionalmedian $1,622 · 10th to 90th $912 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 $912.01 Median $1,584.89 Typical High $11,481.54 | Facility | None | $912.01 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | None | $912.01 | $912.01 | $1,023.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,698.24 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,202.26 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $3,311.31 | Facility | None | $912.01 | $1,096.48 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,148.15 | $1,479.11 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,238.72 | Professional | None | $870.96 | $1,230.27 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $575.44 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $537.03 | $575.44 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $229.09 Typical High $524.81 | Professional | 80 · Assistant surgeon | $213.80 | $229.09 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $162.18 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $147.91 | $162.18 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $162.18 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $162.18 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $162.18 Typical High $363.08 | Professional | AS · PA/NP assist | $147.91 | $162.18 | $363.08 |
Where North Carolina sits
The same service costs 6.3 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· 12th of 51
$1,622
AK $3,715UT $589
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.