How much rates vary
Facilitymedian $3,020 · 10th to 90th $871 to $10,471Professionalmedian $955 · 10th to 90th $589 to $1,862
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 $707.95 Median $707.95 Typical High $7,943.28 | Facility | None | $707.95 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | None | $707.95 | $707.95 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,570.88 | Facility | None | $2,187.76 | $3,235.94 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,949.84 | Professional | None | $588.84 | $1,148.15 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,890.45 | Facility | None | $602.56 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,548.82 | Professional | None | $741.31 | $758.58 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,122.02 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $6,165.95 | Facility | None | $758.58 | $2,691.53 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,148.15 | Professional | None | $776.25 | $870.96 | $1,148.15 |
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 $575.44 Median $741.31 Typical High $1,698.24 | Professional | None | $575.44 | $741.31 | $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 $354.81 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,380.38 Typical High $2,511.89 | Professional | 50 · Both sides | $1,230.27 | $1,380.38 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $457.09 Typical High $851.14 | Professional | 51 · Multiple procedures | $407.38 | $457.09 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $181.97 Typical High $338.84 | Professional | 80 · Assistant surgeon | $162.18 | $181.97 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $128.82 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $114.82 | $128.82 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $128.82 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $128.82 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $128.82 Typical High $234.42 | Professional | AS · PA/NP assist | $114.82 | $128.82 | $234.42 |
Where North Carolina sits
The same service costs 19.5 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· 23rd of 51
$1,000
AK $2,951TX $151
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.