How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $12,589Professionalmedian $1,950 · 10th to 90th $1,230 to $3,311
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 $1,174.90 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,174.90 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,174.90 | $1,348.96 |
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 $1,513.56 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,137.96 | $3,467.37 |
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 $1,412.54 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,445.44 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $17,782.79 | Facility | None | $1,174.90 | $5,128.61 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,659.59 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,348.96 | $2,884.03 |
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 $588.84 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,511.89 Typical High $4,168.69 | Professional | 50 · Both sides | $2,238.72 | $2,511.89 | $4,168.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $831.76 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $758.58 | $831.76 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $331.13 Typical High $562.34 | Professional | 80 · Assistant surgeon | $302.00 | $331.13 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $234.42 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $208.93 | $234.42 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $234.42 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $234.42 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $234.42 Typical High $389.05 | Professional | AS · PA/NP assist | $208.93 | $234.42 | $389.05 |
Where North Carolina sits
The same service costs 8.7 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· 11th of 51
$1,950
AK $4,786TX $550
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.