How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,096 to $13,490Professionalmedian $1,905 · 10th to 90th $1,148 to $2,951
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 $1,096.48 Median $1,479.11 Typical High $15,135.61 | Facility | None | $1,096.48 | $1,479.11 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,137.96 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $7,413.10 Typical High $12,302.69 | Facility | None | $891.25 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,513.56 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,318.26 | $4,073.80 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,445.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,466.84 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,466.84 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,584.89 | $2,754.23 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $724.44 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $691.83 | $724.44 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $288.40 Typical High $645.65 | Professional | 80 · Assistant surgeon | $281.84 | $288.40 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $204.17 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $194.98 | $204.17 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $204.17 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $204.17 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $204.17 Typical High $457.09 | Professional | AS · PA/NP assist | $194.98 | $204.17 | $457.09 |
Where North Carolina sits
The same service costs 8.7 times more in Oklahoma 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· 17th of 51
$1,905
OK $6,166TX $708
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.