How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,047 to $8,318Professionalmedian $3,020 · 10th to 90th $1,585 to $4,266
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 $1,513.56 Median $1,513.56 Typical High $10,471.29 | Facility | None | $1,513.56 | $1,513.56 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $5,370.32 | Facility | None | $2,089.30 | $3,388.44 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $4,466.84 | Professional | None | $1,949.84 | $3,019.95 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $5,011.87 | Facility | None | $602.56 | $3,019.95 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $3,801.89 | Professional | None | $1,698.24 | $1,737.80 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,570.40 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,548.82 | $5,623.41 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,819.70 | $1,949.84 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,698.24 | $3,715.35 |
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 $758.58 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,230.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $2,884.03 Typical High $5,495.41 | Professional | 50 · Both sides | $2,884.03 | $2,884.03 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $977.24 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $954.99 | $977.24 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $389.05 Typical High $724.44 | Professional | 80 · Assistant surgeon | $380.19 | $389.05 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $269.15 | $269.15 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $269.15 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | AS · PA/NP assist | $269.15 | $269.15 | $512.86 |
Where North Carolina sits
The same service costs 16.2 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· 6th of 51
$3,020
AK $6,310TX $389
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.