How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,122 to $13,804Professionalmedian $3,236 · 10th to 90th $1,660 to $4,169
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 $1,288.25 Median $1,621.81 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,621.81 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,621.81 | $2,630.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,165.95 Median $10,000.00 Typical High $15,848.93 | Facility | None | $6,165.95 | $10,000.00 | $15,848.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $3,630.78 Typical High $4,168.69 | Professional | None | $1,949.84 | $3,630.78 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $4,265.80 | Professional | None | $1,819.70 | $1,862.09 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,754.23 | $2,754.23 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,122.02 | $5,128.61 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,187.76 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,819.70 | $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 $812.83 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $812.83 | $812.83 | $912.01 |
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 $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $275.42 |
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 $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $4,073.80 Typical High $5,888.44 | Professional | 50 · Both sides | $3,090.30 | $4,073.80 | $5,888.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,348.96 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $1,023.29 | $1,348.96 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $537.03 Typical High $776.25 | Professional | 80 · Assistant surgeon | $407.38 | $537.03 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $380.19 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $288.40 | $380.19 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $380.19 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $380.19 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $380.19 Typical High $549.54 | Professional | AS · PA/NP assist | $288.40 | $380.19 | $549.54 |
Where North Carolina sits
The same service costs 7.8 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
$3,311
AK $6,761TX $871
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.