How much rates vary
Facilitymedian $14,791 · 10th to 90th $1,660 to $28,184Professionalmedian $5,623 · 10th to 90th $3,715 to $10,715
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 $3,801.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,801.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,801.89 | $3,801.89 | $4,466.84 |
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 $3,715.35 Median $7,079.46 Typical High $10,715.19 | Professional | None | $3,715.35 | $7,079.46 | $10,715.19 |
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 $4,677.35 Median $4,786.30 Typical High $9,772.37 | Professional | None | $4,677.35 | $4,786.30 | $9,772.37 |
Medcost Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $9,120.11 | Professional | None | $7,079.46 | $7,079.46 | $9,120.11 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $37,153.52 | Facility | None | $2,570.40 | $2,570.40 | $37,153.52 |
Medcost Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $6,309.57 | Professional | None | $4,677.35 | $5,495.41 | $6,309.57 |
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 $3,311.31 Median $4,570.88 Typical High $9,549.93 | Professional | None | $3,311.31 | $4,570.88 | $9,549.93 |
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 $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $3,162.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7,762.47 Median $8,128.31 Typical High $13,803.84 | Professional | 50 · Both sides | $7,762.47 | $8,128.31 | $13,803.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,570.40 Median $2,754.23 Typical High $4,570.88 | Professional | 51 · Multiple procedures | $2,570.40 | $2,754.23 | $4,570.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,023.29 Median $1,096.48 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $1,023.29 | $1,096.48 | $1,862.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $724.44 Median $758.58 Typical High $1,288.25 | Professional | 81 · Minimal assistant surgeon | $724.44 | $758.58 | $1,288.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $724.44 Median $758.58 Typical High $1,288.25 | Professional | 82 · Assistant surgeon, no resident | $724.44 | $758.58 | $1,288.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $724.44 Median $758.58 Typical High $1,288.25 | Professional | AS · PA/NP assist | $724.44 | $758.58 | $1,288.25 |
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
$5,888
AK $15,849TX $776
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.