How much rates vary
Facilitymedian $1,738 · 10th to 90th $794 to $4,677Professionalmedian $977 · 10th to 90th $794 to $1,995
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 $1,288.25 Typical High $8,317.64 | Facility | None | $870.96 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,288.25 | Professional | None | $870.96 | $870.96 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,819.70 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $2,089.30 | Professional | None | $851.14 | $977.24 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $2,454.71 | Facility | None | $645.65 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,949.84 | Professional | None | $870.96 | $933.25 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,258.93 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,023.29 Typical High $2,691.53 | Facility | None | $602.56 | $1,023.29 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,096.48 | Professional | None | $758.58 | $1,047.13 | $1,096.48 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $2,041.74 | Professional | None | $707.95 | $870.96 | $2,041.74 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,548.82 Typical High $4,365.16 | Facility | 50 · Both sides | $891.25 | $1,548.82 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $512.86 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $295.12 | $512.86 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $1,148.15 | $1,584.89 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $524.81 Typical High $707.95 | Professional | 51 · Multiple procedures | $380.19 | $524.81 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $151.36 | $208.93 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $107.15 | $147.91 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $147.91 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $107.15 | $147.91 | $199.53 |
Where North Carolina sits
The same service costs 7.6 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· 33rd of 51
$1,000
AK $3,631TX $479
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.