How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,202 to $11,749Professionalmedian $1,862 · 10th to 90th $1,230 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 $1,318.26 Median $1,318.26 Typical High $10,471.29 | Facility | None | $1,318.26 | $1,318.26 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,801.89 Median $6,309.57 Typical High $9,772.37 | Facility | None | $3,801.89 | $6,309.57 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,230.27 | $2,398.83 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,495.41 Typical High $9,120.11 | Facility | None | $602.56 | $5,495.41 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,548.82 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,187.76 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $4,466.84 Typical High $14,454.40 | Facility | None | $1,380.38 | $4,466.84 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,737.80 | $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 $1,479.11 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,479.11 | $3,235.94 |
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 $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $4,786.30 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $870.96 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $691.83 | $870.96 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $630.96 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $245.47 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $190.55 | $245.47 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $245.47 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $245.47 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $245.47 Typical High $446.68 | Professional | AS · PA/NP assist | $190.55 | $245.47 | $446.68 |
Where North Carolina sits
The same service costs 18.6 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· 21st of 51
$1,995
AK $5,370TX $288
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.