How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,514 · 10th to 90th $1,023 to $2,754
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 $1,000.00 Median $1,174.90 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,174.90 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,819.70 | $2,884.03 |
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 $977.24 Median $1,318.26 Typical High $2,884.03 | Professional | None | $977.24 | $1,318.26 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $3,548.13 | Facility | None | $1,174.90 | $1,380.38 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,202.26 | $1,905.46 |
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 $977.24 Median $1,288.25 Typical High $2,884.03 | Professional | None | $977.24 | $1,288.25 | $2,884.03 |
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 $575.44 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $602.56 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $537.03 | $602.56 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $660.69 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $165.96 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $151.36 | $165.96 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $165.96 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $165.96 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $165.96 Typical High $457.09 | Professional | AS · PA/NP assist | $151.36 | $165.96 | $457.09 |
Where North Carolina sits
The same service costs 5.6 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· 30th of 51
$1,445
AK $5,012UT $891
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.