How much rates vary
Facilitymedian $2,399 · 10th to 90th $741 to $7,079Professionalmedian $977 · 10th to 90th $617 to $1,622
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 $602.56 Median $1,288.25 Typical High $10,471.29 | Facility | None | $602.56 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | None | $602.56 | $602.56 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,818.38 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,737.80 | Professional | None | $758.58 | $1,071.52 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,467.37 | Facility | None | $794.33 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,202.26 | Professional | None | $616.60 | $616.60 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,445.44 | Professional | None | $912.01 | $912.01 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,479.11 Typical High $2,754.23 | Facility | None | $724.44 | $1,479.11 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $831.76 | Professional | None | $575.44 | $741.31 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | None | $707.95 | $707.95 | $741.31 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
14 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 $302.00 Median $302.00 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $512.86 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,238.72 Typical High $5,370.32 | Facility | 50 · Both sides | $1,096.48 | $2,238.72 | $5,370.32 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $741.31 Typical High $1,778.28 | Facility | 51 · Multiple procedures | $363.08 | $741.31 | $1,778.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,122.02 Typical High $1,513.56 | Professional | 50 · Both sides | $870.96 | $1,122.02 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $371.54 Typical High $512.86 | Professional | 51 · Multiple procedures | $288.40 | $371.54 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | 80 · Assistant surgeon | $114.82 | $147.91 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $104.71 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $81.28 | $104.71 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $104.71 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $104.71 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $104.71 Typical High $141.25 | Professional | AS · PA/NP assist | $81.28 | $104.71 | $141.25 |
Where North Carolina sits
The same service costs 5.9 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· 14th of 51
$977
AK $2,512TX $427
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.