How much rates vary
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,202.26 | $1,318.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $5,888.44 | Facility | None | $3,019.95 | $4,365.16 | $5,888.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,148.15 | $2,089.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,513.56 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,000.00 | $1,202.26 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,412.54 | $1,949.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,380.38 | $2,951.21 |
8 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 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,137.96 Typical High $5,128.61 | Professional | 50 · Both sides | $1,659.59 | $2,137.96 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $707.95 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $549.54 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $288.40 Typical High $691.83 | Professional | 80 · Assistant surgeon | $223.87 | $288.40 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $199.53 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $154.88 | $199.53 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $199.53 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $199.53 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $199.53 Typical High $478.63 | Professional | AS · PA/NP assist | $154.88 | $199.53 | $478.63 |
Where North Carolina sits
The same service costs 6.8 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· 19th of 51
$1,622
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.