How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,380 to $10,715Professionalmedian $1,995 · 10th to 90th $1,175 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 $1,445.44 Median $1,513.56 Typical High $10,715.19 | Facility | None | $1,445.44 | $1,513.56 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,570.88 | Facility | None | $2,187.76 | $3,235.94 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $4,265.80 | Professional | None | $1,412.54 | $1,995.26 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,890.45 | Facility | None | $602.56 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $3,311.31 | Professional | None | $1,071.52 | $1,230.27 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,659.59 | $1,659.59 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $6,165.95 | Facility | None | $1,548.82 | $4,168.69 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,698.24 | $2,398.83 |
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 $1,047.13 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,513.56 | $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 $741.31 Median $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $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 $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $257.04 |
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 $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,202.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,570.40 Typical High $5,370.32 | Professional | 50 · Both sides | $2,089.30 | $2,570.40 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $851.14 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $707.95 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $724.44 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $501.19 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $501.19 |
Where North Carolina sits
The same service costs 8.5 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
$1,995
AK $6,166TX $724
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.