How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,380 to $12,882Professionalmedian $1,259 · 10th to 90th $589 to $2,455
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 $870.96 Median $1,445.44 Typical High $10,715.19 | Facility | None | $870.96 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | None | $870.96 | $870.96 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $8,511.38 | Facility | None | $3,311.31 | $5,370.32 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $1,513.56 Typical High $2,570.40 | Professional | None | $588.84 | $1,513.56 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $6,760.83 Typical High $11,220.18 | Facility | None | $1,584.89 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $2,187.76 | Professional | None | $977.24 | $1,000.00 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,479.11 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $8,511.38 Typical High $17,782.79 | Facility | None | $933.25 | $8,511.38 | $17,782.79 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,202.26 | $1,445.44 |
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 $741.31 Median $977.24 Typical High $2,187.76 | Professional | None | $741.31 | $977.24 | $2,187.76 |
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 $436.52 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $3,162.28 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $537.03 | $630.96 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $426.58 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $151.36 | $177.83 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $177.83 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $295.12 |
Where North Carolina sits
The same service costs 13.8 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· 23rd of 51
$1,318
AK $3,631TX $263
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.