How much rates vary
Facilitymedian $3,388 · 10th to 90th $851 to $8,318Professionalmedian $1,202 · 10th to 90th $871 to $2,512
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 $851.14 Median $1,288.25 Typical High $8,317.64 | Facility | None | $851.14 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,445.44 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,073.80 Typical High $6,025.60 | Facility | None | $645.65 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $2,137.96 | Professional | None | $933.25 | $954.99 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,348.96 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $4,265.80 | Facility | None | $588.84 | $1,548.82 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $2,089.30 | Professional | None | $724.44 | $933.25 | $2,089.30 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $691.83 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,019.95 Typical High $8,709.64 | Facility | 50 · Both sides | $891.25 | $3,019.95 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $295.12 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,621.81 Typical High $3,090.30 | Professional | 50 · Both sides | $1,621.81 | $1,621.81 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $537.03 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $537.03 | $537.03 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $218.78 Typical High $407.38 | Professional | 80 · Assistant surgeon | $213.80 | $218.78 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $151.36 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $151.36 | $151.36 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $151.36 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $151.36 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $151.36 Typical High $288.40 | Professional | AS · PA/NP assist | $151.36 | $151.36 | $288.40 |
Where North Carolina sits
The same service costs 20.9 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· 23rd of 51
$1,259
AK $3,467TX $166
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.