How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,175 to $13,804Professionalmedian $2,399 · 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 $1,949.84 | Professional | None | $1,174.90 | $1,174.90 | $1,949.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,943.28 Typical High $12,302.69 | Facility | None | $4,786.30 | $7,943.28 | $12,302.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,511.89 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,918.31 Typical High $11,481.54 | Facility | None | $602.56 | $6,918.31 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,348.96 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,949.84 | $1,949.84 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $4,570.88 Typical High $18,197.01 | Facility | None | $1,258.93 | $4,570.88 | $18,197.01 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,479.11 | $1,949.84 |
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 $1,023.29 Median $1,318.26 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,318.26 | $2,951.21 |
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 $691.83 | Professional | 52 · Reduced service | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $954.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,238.72 Typical High $4,365.16 | Professional | 50 · Both sides | $1,995.26 | $2,238.72 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $741.31 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $660.69 | $741.31 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $295.12 Typical High $575.44 | Professional | 80 · Assistant surgeon | $263.03 | $295.12 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $208.93 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $186.21 | $208.93 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $208.93 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $208.93 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $208.93 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $208.93 | $407.38 |
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· 8th of 51
$2,455
AK $5,012TX $575
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.