How much rates vary
Facilitymedian $2,884 · 10th to 90th $871 to $7,586Professionalmedian $2,042 · 10th to 90th $1,148 to $3,236
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 $1,096.48 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $3,890.45 | Facility | None | $1,905.46 | $2,884.03 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,041.74 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,365.16 | Facility | None | $602.56 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,258.93 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,819.70 | $2,570.40 |
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 $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
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 $933.25 Median $1,318.26 Typical High $2,691.53 | Professional | None | $933.25 | $1,318.26 | $2,691.53 |
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 $549.54 Median $549.54 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $912.01 |
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 $630.96 Median $691.83 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $630.96 | $691.83 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $275.42 Typical High $524.81 | Professional | 80 · Assistant surgeon | $251.19 | $275.42 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $190.55 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $177.83 | $190.55 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $190.55 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $190.55 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $190.55 Typical High $371.54 | Professional | AS · PA/NP assist | $177.83 | $190.55 | $371.54 |
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
$2,042
AK $4,571UT $741
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.