How much rates vary
Facilitymedian $3,388 · 10th to 90th $741 to $10,233Professionalmedian $2,399 · 10th to 90th $1,413 to $3,890
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 $1,348.96 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,348.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,348.96 | $2,137.96 |
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 $1,819.70 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,398.83 | $3,981.07 |
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 $1,445.44 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,513.56 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,187.76 | $3,162.28 |
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 $1,584.89 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,698.24 | $2,187.76 |
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 $1,148.15 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,621.81 | $3,311.31 |
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 $676.08 Median $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,122.02 |
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 $851.14 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $338.84 Typical High $645.65 | Professional | 80 · Assistant surgeon | $316.23 | $338.84 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $239.88 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $218.78 | $239.88 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $239.88 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $239.88 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $239.88 Typical High $457.09 | Professional | AS · PA/NP assist | $218.78 | $239.88 | $457.09 |
Where North Carolina sits
The same service costs 7.2 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· 11th of 51
$2,399
AK $5,495TX $759
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.