How much rates vary
Facilitymedian $3,162 · 10th to 90th $851 to $10,000Professionalmedian $2,239 · 10th to 90th $1,445 to $4,074
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 $1,380.38 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,380.38 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,890.45 | Facility | None | $1,905.46 | $2,818.38 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,398.83 | $4,073.80 |
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 $1,479.11 Median $1,548.82 Typical High $3,548.13 | Professional | None | $1,479.11 | $1,548.82 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,238.72 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $4,897.79 | Facility | None | $602.56 | $1,513.56 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
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 $1,202.26 Median $1,698.24 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,698.24 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
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 $776.25 Median $933.25 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $776.25 | $933.25 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $676.08 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $263.03 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $218.78 | $263.03 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $263.03 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $263.03 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $263.03 Typical High $467.74 | Professional | AS · PA/NP assist | $218.78 | $263.03 | $467.74 |
Where North Carolina sits
The same service costs 24.5 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· 17th of 51
$2,239
AK $5,754TX $234
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.