How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $5,754Professionalmedian $661 · 10th to 90th $389 to $1,072
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 $363.08 Median $416.87 Typical High $8,128.31 | Facility | None | $363.08 | $416.87 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $575.44 | Professional | None | $363.08 | $416.87 | $575.44 |
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 $467.74 Median $758.58 Typical High $1,096.48 | Professional | None | $467.74 | $758.58 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,467.37 | Facility | None | $912.01 | $2,818.38 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $2,398.83 | Facility | None | $501.19 | $954.99 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $707.95 | Professional | None | $436.52 | $524.81 | $707.95 |
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 $354.81 Median $512.86 Typical High $1,000.00 | Professional | None | $354.81 | $512.86 | $1,000.00 |
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 $181.97 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $72.44 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $275.42 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $36.31 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $295.12 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $512.86 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $416.87 | $512.86 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $257.04 Typical High $575.44 | Professional | 51 · Multiple procedures | $218.78 | $257.04 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $104.71 Typical High $229.09 | Professional | 80 · Assistant surgeon | $87.10 | $104.71 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $61.66 | $72.44 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $72.44 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $158.49 |
Where North Carolina sits
The same service costs 3.8 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· 9th of 51
$708
AK $1,349UT $355
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.