How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,230 to $12,303Professionalmedian $5,129 · 10th to 90th $3,548 to $10,000
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 $1,584.89 Median $3,715.35 Typical High $10,471.29 | Facility | None | $1,584.89 | $3,715.35 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,265.80 | Professional | None | $3,715.35 | $3,715.35 | $4,265.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $12,022.64 | Facility | None | $4,677.35 | $7,762.47 | $12,022.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $10,471.29 | Professional | None | $3,548.13 | $6,606.93 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,760.83 Typical High $11,220.18 | Facility | None | $602.56 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $8,317.64 | Professional | None | $4,168.69 | $4,365.16 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,912.51 | Professional | None | $6,606.93 | $6,606.93 | $8,912.51 |
Medcost Setting Facility Modifier None Typical Low $3,801.89 Median $12,589.25 Typical High $17,782.79 | Facility | None | $3,801.89 | $12,589.25 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,677.35 Typical High $6,165.95 | Professional | None | $4,265.80 | $4,677.35 | $6,165.95 |
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 $3,162.28 Median $4,073.80 Typical High $9,120.11 | Professional | None | $3,162.28 | $4,073.80 | $9,120.11 |
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 $1,862.09 Median $1,862.09 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 53 · Discontinued | $741.31 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $3,019.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,309.57 Median $7,079.46 Typical High $13,489.63 | Professional | 50 · Both sides | $6,309.57 | $7,079.46 | $13,489.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,137.96 Median $2,344.23 Typical High $4,466.84 | Professional | 51 · Multiple procedures | $2,137.96 | $2,344.23 | $4,466.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $851.14 Median $933.25 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $851.14 | $933.25 | $1,778.28 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $660.69 Typical High $1,258.93 | Professional | 81 · Minimal assistant surgeon | $588.84 | $660.69 | $1,258.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $660.69 Typical High $1,258.93 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $660.69 | $1,258.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $660.69 Typical High $1,258.93 | Professional | AS · PA/NP assist | $588.84 | $660.69 | $1,258.93 |
Where North Carolina sits
The same service costs 20.4 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· 18th of 51
$5,248
AK $15,488TX $759
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.