How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,380 to $13,490Professionalmedian $2,951 · 10th to 90th $1,549 to $4,365
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 $1,445.44 Median $1,548.82 Typical High $10,715.19 | Facility | None | $1,445.44 | $1,548.82 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
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 $1,819.70 Median $2,951.21 Typical High $4,365.16 | Professional | None | $1,819.70 | $2,951.21 | $4,365.16 |
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 $1,479.11 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,479.11 | $1,584.89 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,290.87 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $6,456.54 Typical High $17,782.79 | Facility | None | $1,584.89 | $6,456.54 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,905.46 | $2,570.40 |
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 $1,318.26 Median $1,698.24 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,698.24 | $3,801.89 |
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 $776.25 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $2,884.03 Typical High $5,623.41 | Professional | 50 · Both sides | $2,630.27 | $2,884.03 | $5,623.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $954.99 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $891.25 | $954.99 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $380.19 Typical High $741.31 | Professional | 80 · Assistant surgeon | $354.81 | $380.19 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $269.15 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $245.47 | $269.15 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $269.15 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $269.15 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $269.15 Typical High $524.81 | Professional | AS · PA/NP assist | $245.47 | $269.15 | $524.81 |
Where North Carolina sits
The same service costs 8.9 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· 9th of 51
$2,951
AK $6,457TX $724
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.