How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,951 · 10th to 90th $1,950 to $4,786
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 $1,288.25 Median $1,949.84 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,949.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,949.84 | $1,949.84 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,511.89 Median $3,548.13 Typical High $5,248.07 | Professional | None | $2,511.89 | $3,548.13 | $5,248.07 |
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 $2,041.74 Median $2,570.40 Typical High $5,248.07 | Professional | None | $2,041.74 | $2,570.40 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $1,949.84 | $2,344.23 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,398.83 | $3,162.28 |
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 $1,862.09 Median $2,570.40 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,570.40 | $4,786.30 |
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 $954.99 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,202.26 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $1,071.52 | $1,202.26 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $478.63 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $426.58 | $478.63 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $331.13 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $302.00 | $331.13 | $776.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $331.13 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $331.13 | $776.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $331.13 Typical High $776.25 | Professional | AS · PA/NP assist | $302.00 | $331.13 | $776.25 |
Where North Carolina sits
The same service costs 7.8 times more in Alaska 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· 16th of 51
$2,951
AK $8,128TX $1,047
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.