How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,072 to $11,749Professionalmedian $1,413 · 10th to 90th $302 to $2,884
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 $1,071.52 Median $1,071.52 Typical High $7,943.28 | Facility | None | $1,071.52 | $1,071.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,071.52 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,890.45 Median $5,754.40 Typical High $7,762.47 | Facility | None | $3,890.45 | $5,754.40 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $1,698.24 Typical High $2,951.21 | Professional | None | $302.00 | $1,698.24 | $2,951.21 |
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 $1,096.48 Median $1,122.02 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,122.02 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,659.59 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,148.15 | $5,248.07 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,318.26 | $1,778.28 |
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 $891.25 Median $1,148.15 Typical High $2,570.40 | Professional | None | $891.25 | $1,148.15 | $2,570.40 |
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 $537.03 Median $537.03 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $1,949.84 Typical High $3,890.45 | Professional | 50 · Both sides | $1,819.70 | $1,949.84 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $660.69 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $616.60 | $660.69 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $263.03 Typical High $524.81 | Professional | 80 · Assistant surgeon | $245.47 | $263.03 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $181.97 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $169.82 | $181.97 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $181.97 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $181.97 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $181.97 Typical High $363.08 | Professional | AS · PA/NP assist | $169.82 | $181.97 | $363.08 |
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
$1,479
AK $4,467TX $324
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.