How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $7,762Professionalmedian $4,169 · 10th to 90th $2,291 to $5,623
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 $2,290.87 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,290.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,290.87 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,951.21 Median $4,168.69 Typical High $5,623.41 | Professional | None | $2,951.21 | $4,168.69 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $29,512.09 | Facility | None | $478.63 | $870.96 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $5,623.41 | Professional | None | $2,290.87 | $2,454.71 | $5,623.41 |
Medcost Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $5,495.41 | Professional | None | $3,548.13 | $3,548.13 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $7,762.47 | Facility | None | $2,290.87 | $2,754.23 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,398.83 | $2,818.38 | $3,715.35 |
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 $1,949.84 Median $2,691.53 Typical High $5,623.41 | Professional | None | $1,949.84 | $2,691.53 | $5,623.41 |
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 $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,412.54 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $1,202.26 | $1,412.54 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $562.34 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $489.78 | $562.34 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $389.05 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $338.84 | $389.05 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $389.05 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $389.05 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $389.05 Typical High $758.58 | Professional | AS · PA/NP assist | $338.84 | $389.05 | $758.58 |
Where North Carolina sits
The same service costs 23.4 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· 11th of 51
$4,169
AK $9,550TX $407
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.