How much rates vary
Facilitymedian $16,218 · 10th to 90th $1,622 to $28,840Professionalmedian $4,571 · 10th to 90th $2,884 to $8,913
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 $3,162.28 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
BCBS North Carolina Setting Facility Modifier None Typical Low $11,748.98 Median $19,054.61 Typical High $30,199.52 | Facility | None | $11,748.98 | $19,054.61 | $30,199.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,884.03 Median $5,495.41 Typical High $8,912.51 | Professional | None | $2,884.03 | $5,495.41 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $19,952.62 Typical High $33,113.11 | Facility | None | $602.56 | $19,952.62 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $3,890.45 Typical High $7,585.78 | Professional | None | $3,715.35 | $3,890.45 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $7,413.10 | Professional | None | $5,623.41 | $5,623.41 | $7,413.10 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $15,135.61 Typical High $52,480.75 | Facility | None | $3,235.94 | $15,135.61 | $52,480.75 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,890.45 | $4,265.80 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $7,762.47 | Professional | None | $2,754.23 | $3,630.78 | $7,762.47 |
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 $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 53 · Discontinued | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,888.44 Median $6,760.83 Typical High $11,481.54 | Professional | 50 · Both sides | $5,888.44 | $6,760.83 | $11,481.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,949.84 Median $2,238.72 Typical High $3,801.89 | Professional | 51 · Multiple procedures | $1,949.84 | $2,238.72 | $3,801.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $776.25 Median $912.01 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $776.25 | $912.01 | $1,513.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $549.54 Median $630.96 Typical High $1,071.52 | Professional | 81 · Minimal assistant surgeon | $549.54 | $630.96 | $1,071.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $549.54 Median $630.96 Typical High $1,071.52 | Professional | 82 · Assistant surgeon, no resident | $549.54 | $630.96 | $1,071.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $630.96 Typical High $1,071.52 | Professional | AS · PA/NP assist | $549.54 | $630.96 | $1,071.52 |
Where North Carolina sits
The same service costs 20.4 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· 18th of 51
$4,786
AK $13,183TX $646
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.