How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,622 to $24,547Professionalmedian $2,188 · 10th to 90th $1,479 to $4,571
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 $1,621.81 Typical High $10,964.78 | Facility | None | $1,584.89 | $1,621.81 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,621.81 | $1,862.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,709.64 Median $14,125.38 Typical High $21,877.62 | Facility | None | $8,709.64 | $14,125.38 | $21,877.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $4,786.30 | Professional | None | $1,479.11 | $2,818.38 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,803.84 Typical High $22,387.21 | Facility | None | $602.56 | $13,803.84 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,819.70 | $1,862.09 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,801.89 | Professional | None | $2,691.53 | $2,691.53 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $5,011.87 Typical High $35,481.34 | Facility | None | $1,659.59 | $5,011.87 | $35,481.34 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,659.59 | $2,041.74 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,778.28 | $3,981.07 |
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 $794.33 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $3,090.30 Typical High $5,754.40 | Professional | 50 · Both sides | $2,511.89 | $3,090.30 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $1,023.29 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $831.76 | $1,023.29 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $407.38 Typical High $776.25 | Professional | 80 · Assistant surgeon | $338.84 | $407.38 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $288.40 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $234.42 | $288.40 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $288.40 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $288.40 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $537.03 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $537.03 |
Where North Carolina sits
The same service costs 17.0 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· 23rd of 51
$2,344
AK $6,607TX $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.