How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,380 to $13,804Professionalmedian $2,884 · 10th to 90th $1,479 to $4,074
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 $1,412.54 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,412.54 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $1,737.80 Median $2,951.21 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,951.21 | $4,265.80 |
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 $1,584.89 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,584.89 | $1,659.59 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,398.83 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $5,888.44 Typical High $17,782.79 | Facility | None | $1,479.11 | $5,888.44 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,905.46 | $2,344.23 |
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 $1,230.27 Median $1,621.81 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,621.81 | $3,548.13 |
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 $707.95 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $2,818.38 Typical High $5,128.61 | Professional | 50 · Both sides | $2,754.23 | $2,818.38 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $933.25 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $912.01 | $933.25 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $380.19 Typical High $691.83 | Professional | 80 · Assistant surgeon | $363.08 | $380.19 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $263.03 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $257.04 | $263.03 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $263.03 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $263.03 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $263.03 Typical High $478.63 | Professional | AS · PA/NP assist | $257.04 | $263.03 | $478.63 |
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
$2,951
AK $5,888TX $676
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.