How much rates vary
Facilitymedian $2,455 · 10th to 90th $692 to $8,318Professionalmedian $1,148 · 10th to 90th $724 to $1,820
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 $691.83 Median $1,288.25 Typical High $10,471.29 | Facility | None | $691.83 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | None | $691.83 | $691.83 | $912.01 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,019.95 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,949.84 | Professional | None | $933.25 | $1,348.96 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $4,168.69 | Facility | None | $602.56 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,862.09 | Professional | None | $776.25 | $1,000.00 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $3,715.35 | Facility | None | $776.25 | $1,905.46 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,230.27 | Professional | None | $794.33 | $954.99 | $1,230.27 |
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 $660.69 Median $870.96 Typical High $1,737.80 | Professional | None | $660.69 | $870.96 | $1,737.80 |
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 $346.74 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,445.44 Typical High $3,090.30 | Professional | 50 · Both sides | $1,258.93 | $1,445.44 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $478.63 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $426.58 | $478.63 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $190.55 Typical High $407.38 | Professional | 80 · Assistant surgeon | $169.82 | $190.55 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $134.90 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $117.49 | $134.90 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $134.90 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $134.90 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $134.90 Typical High $288.40 | Professional | AS · PA/NP assist | $117.49 | $134.90 | $288.40 |
Where North Carolina sits
The same service costs 6.3 times more in Oklahoma than in Utah. 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· 20th of 51
$1,148
OK $3,311UT $525
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.