How much rates vary
Facilitymedian $1,905 · 10th to 90th $603 to $5,754Professionalmedian $603 · 10th to 90th $324 to $1,175
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 $436.52 Median $1,047.13 Typical High $8,317.64 | Facility | None | $436.52 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | None | $436.52 | $436.52 | $588.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,778.28 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $776.25 Typical High $1,230.27 | Professional | None | $323.59 | $776.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $3,467.37 | Facility | None | $645.65 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,071.52 | Professional | None | $446.68 | $562.34 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $891.25 Typical High $2,398.83 | Facility | None | $575.44 | $891.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $933.25 | Professional | None | $467.74 | $537.03 | $933.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $1,071.52 | Professional | None | $426.58 | $575.44 | $1,071.52 |
12 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 $213.80 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $338.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $478.63 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $295.12 | $478.63 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $269.15 Typical High $602.56 | Professional | 51 · Multiple procedures | $234.42 | $269.15 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $107.15 Typical High $245.47 | Professional | 80 · Assistant surgeon | $93.33 | $107.15 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $75.86 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $66.07 | $75.86 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $75.86 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $75.86 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $75.86 Typical High $169.82 | Professional | AS · PA/NP assist | $66.07 | $75.86 | $169.82 |
Where North Carolina sits
The same service costs 7.1 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
$708
AK $2,042UT $288
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.