How much rates vary
Facilitymedian $3,388 · 10th to 90th $741 to $10,965Professionalmedian $2,512 · 10th to 90th $1,288 to $3,631
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 $1,230.27 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,230.27 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,230.27 | $1,479.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,019.95 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,511.89 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $7,079.46 Typical High $10,471.29 | Facility | None | $645.65 | $7,079.46 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,412.54 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,041.74 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $5,128.61 | Facility | None | $602.56 | $1,513.56 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,584.89 | $2,041.74 |
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 $1,071.52 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,479.11 | $3,090.30 |
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 $616.60 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,023.29 |
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 $776.25 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $724.44 | $776.25 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $316.23 Typical High $602.56 | Professional | 80 · Assistant surgeon | $295.12 | $316.23 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $218.78 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $204.17 | $218.78 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $218.78 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $218.78 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $218.78 Typical High $416.87 | Professional | AS · PA/NP assist | $204.17 | $218.78 | $416.87 |
Where North Carolina sits
The same service costs 7.4 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· 7th of 51
$2,512
AK $5,129TX $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.