How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,047 to $21,878Professionalmedian $1,585 · 10th to 90th $933 to $2,951
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 $1,047.13 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,047.13 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,709.64 Median $14,125.38 Typical High $21,877.62 | Facility | None | $8,709.64 | $14,125.38 | $21,877.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,819.70 Typical High $3,090.30 | Professional | None | $933.25 | $1,819.70 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,803.84 Typical High $22,387.21 | Facility | None | $602.56 | $13,803.84 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,202.26 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $35,481.34 | Facility | None | $1,047.13 | $1,949.84 | $35,481.34 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,318.26 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,691.53 | Professional | None | $891.25 | $1,445.44 | $2,691.53 |
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 $524.81 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,511.89 Typical High $3,890.45 | Professional | 50 · Both sides | $1,905.46 | $2,511.89 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $851.14 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $630.96 | $851.14 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $338.84 Typical High $512.86 | Professional | 80 · Assistant surgeon | $257.04 | $338.84 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $234.42 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $177.83 | $234.42 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $234.42 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $234.42 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $234.42 Typical High $363.08 | Professional | AS · PA/NP assist | $177.83 | $234.42 | $363.08 |
Where North Carolina sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 20th of 51
$1,698
AK $4,467HI $95.50
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.