How much rates vary
Facilitymedian $1,479 · 10th to 90th $708 to $5,248Professionalmedian $1,380 · 10th to 90th $871 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 $1,071.52 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,071.52 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,071.52 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $2,754.23 | Professional | None | $870.96 | $1,548.82 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,398.83 | Facility | None | $741.31 | $1,584.89 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $2,630.27 | Professional | None | $912.01 | $977.24 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,348.96 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $954.99 Typical High $2,089.30 | Facility | None | $524.81 | $954.99 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,023.29 | $1,513.56 |
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 $870.96 Median $1,096.48 Typical High $2,570.40 | Professional | None | $870.96 | $1,096.48 | $2,570.40 |
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 $524.81 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $851.14 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $467.74 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $257.04 | $467.74 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $512.86 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $501.19 | $512.86 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $204.17 Typical High $512.86 | Professional | 80 · Assistant surgeon | $199.53 | $204.17 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $144.54 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $138.04 | $144.54 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $144.54 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $144.54 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $144.54 Typical High $354.81 | Professional | AS · PA/NP assist | $138.04 | $144.54 | $354.81 |
Where North Carolina sits
The same service costs 5.9 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· 22nd of 51
$1,380
AK $4,467TX $759
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.