How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $12,882Professionalmedian $1,862 · 10th to 90th $1,072 to $3,020
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 $1,023.29 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,023.29 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,090.30 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,862.09 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,912.51 Typical High $13,182.57 | Facility | None | $602.56 | $8,912.51 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,148.15 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,698.24 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $5,128.61 | Facility | None | $549.54 | $1,513.56 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,288.25 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,511.89 | Professional | None | $891.25 | $1,230.27 | $2,511.89 |
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 $512.86 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $851.14 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $758.58 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $263.03 | $758.58 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $645.65 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $588.84 | $645.65 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $257.04 Typical High $501.19 | Professional | 80 · Assistant surgeon | $234.42 | $257.04 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $181.97 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $165.96 | $181.97 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $181.97 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $181.97 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $181.97 Typical High $346.74 | Professional | AS · PA/NP assist | $165.96 | $181.97 | $346.74 |
Where North Carolina sits
The same service costs 6.2 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· 11th of 51
$1,862
AK $4,266UT $692
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.