How much rates vary
Facilitymedian $6,026 · 10th to 90th $813 to $14,454Professionalmedian $1,259 · 10th to 90th $871 to $2,399
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 $812.83 Median $1,202.26 Typical High $10,715.19 | Facility | None | $812.83 | $1,202.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | None | $812.83 | $812.83 | $1,000.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $20,892.96 | Facility | None | $5,248.07 | $8,128.31 | $20,892.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,659.59 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $12,302.69 | Facility | None | $602.56 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,148.15 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $5,248.07 Typical High $9,120.11 | Facility | None | $954.99 | $5,248.07 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,318.26 | Professional | None | $812.83 | $1,122.02 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,995.26 | Professional | None | $794.33 | $1,148.15 | $1,995.26 |
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 $398.11 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $562.34 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $512.86 | $562.34 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $223.87 Typical High $467.74 | Professional | 80 · Assistant surgeon | $204.17 | $223.87 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $154.88 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $144.54 | $154.88 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $154.88 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $154.88 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $154.88 Typical High $323.59 | Professional | AS · PA/NP assist | $144.54 | $154.88 | $323.59 |
Where North Carolina sits
The same service costs 11.0 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· 16th of 51
$1,380
OK $5,888UT $537
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.