How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,380 to $13,490Professionalmedian $2,754 · 10th to 90th $1,738 to $4,677
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 $1,659.59 Typical High $10,715.19 | Facility | None | $1,445.44 | $1,659.59 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,659.59 | $1,659.59 | $2,818.38 |
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 $2,041.74 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,041.74 | $3,019.95 | $4,897.79 |
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 $1,905.46 Median $1,949.84 Typical High $4,168.69 | Professional | None | $1,905.46 | $1,949.84 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,884.03 | $2,884.03 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $6,918.31 Typical High $17,782.79 | Facility | None | $1,698.24 | $6,918.31 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,238.72 | $2,754.23 |
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 $1,445.44 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,445.44 | $1,862.09 | $4,073.80 |
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 $831.76 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,348.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,311.31 Typical High $6,025.60 | Professional | 50 · Both sides | $3,162.28 | $3,311.31 | $6,025.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,122.02 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,071.52 | $1,122.02 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $446.68 Typical High $794.33 | Professional | 80 · Assistant surgeon | $426.58 | $446.68 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $309.03 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $295.12 | $309.03 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $309.03 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $309.03 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $309.03 Typical High $562.34 | Professional | AS · PA/NP assist | $295.12 | $309.03 | $562.34 |
Where North Carolina sits
The same service costs 9.3 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· 12th of 51
$2,754
AK $6,918TX $741
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.