How much rates vary
Facilitymedian $5,754 · 10th to 90th $871 to $12,882Professionalmedian $1,413 · 10th to 90th $724 to $1,995
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 $691.83 Median $691.83 Typical High $7,943.28 | Facility | None | $691.83 | $691.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,897.79 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,897.79 | $7,244.36 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,041.74 | Professional | None | $933.25 | $1,445.44 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,698.24 | Professional | None | $831.76 | $977.24 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $13,803.84 | Facility | None | $741.31 | $3,388.44 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,202.26 | Professional | None | $831.76 | $954.99 | $1,202.26 |
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 $588.84 Median $851.14 Typical High $1,698.24 | Professional | None | $588.84 | $851.14 | $1,698.24 |
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 $346.74 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,445.44 Typical High $2,511.89 | Professional | 50 · Both sides | $1,288.25 | $1,445.44 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $478.63 Typical High $831.76 | Professional | 51 · Multiple procedures | $426.58 | $478.63 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $190.55 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $190.55 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $134.90 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $120.23 | $134.90 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $134.90 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $134.90 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $134.90 Typical High $234.42 | Professional | AS · PA/NP assist | $120.23 | $134.90 | $234.42 |
Where North Carolina sits
The same service costs 8.7 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· 7th of 51
$1,445
AK $2,884TX $331
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.