How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,230 to $10,965Professionalmedian $1,698 · 10th to 90th $1,259 to $3,467
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 $1,258.93 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,258.93 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,258.93 | $1,445.44 |
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 $1,513.56 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,137.96 | $3,630.78 |
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 $1,348.96 Median $1,412.54 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,412.54 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,041.74 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $4,570.88 Typical High $14,454.40 | Facility | None | $1,258.93 | $4,570.88 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,548.82 | $2,041.74 |
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 $1,071.52 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,348.96 | $3,090.30 |
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 $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,290.87 Typical High $4,570.88 | Professional | 50 · Both sides | $2,187.76 | $2,290.87 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $776.25 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $724.44 | $776.25 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $309.03 Typical High $602.56 | Professional | 80 · Assistant surgeon | $288.40 | $309.03 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $213.80 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $204.17 | $213.80 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $213.80 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $213.80 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $213.80 Typical High $426.58 | Professional | AS · PA/NP assist | $204.17 | $213.80 | $426.58 |
Where North Carolina sits
The same service costs 17.8 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· 22nd of 51
$1,778
AK $5,129TX $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.