How much rates vary
Facilitymedian $3,388 · 10th to 90th $741 to $10,233Professionalmedian $2,570 · 10th to 90th $1,318 to $3,802
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 $1,288.25 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
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 $1,737.80 Median $2,570.40 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,570.40 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,623.41 Typical High $8,317.64 | Facility | None | $645.65 | $5,623.41 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,412.54 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,019.95 | Professional | None | $2,041.74 | $2,041.74 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,786.30 | Facility | None | $602.56 | $1,513.56 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,621.81 | $2,137.96 |
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 $1,096.48 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,548.82 | $3,162.28 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,096.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $758.58 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $295.12 | $758.58 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $812.83 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $724.44 | $812.83 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $323.59 Typical High $616.60 | Professional | 80 · Assistant surgeon | $288.40 | $323.59 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $229.09 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $204.17 | $229.09 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $229.09 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $229.09 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $436.52 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $436.52 |
Where North Carolina sits
The same service costs 11.0 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· 8th of 51
$2,570
AK $5,370TX $490
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.