How much rates vary
Facilitymedian $2,138 · 10th to 90th $525 to $8,318Professionalmedian $562 · 10th to 90th $178 to $1,072
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 $323.59 Median $436.52 Typical High $7,943.28 | Facility | None | $323.59 | $436.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $467.74 | Professional | None | $323.59 | $436.52 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $645.65 Typical High $1,202.26 | Professional | None | $177.83 | $645.65 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,951.21 | Facility | None | $645.65 | $2,089.30 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $954.99 | Professional | None | $323.59 | $446.68 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,047.13 | Professional | None | $616.60 | $616.60 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $2,344.23 | Facility | None | $446.68 | $977.24 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $724.44 | Professional | None | $398.11 | $524.81 | $724.44 |
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 $288.40 Median $416.87 Typical High $891.25 | Professional | None | $288.40 | $416.87 | $891.25 |
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 $158.49 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $158.49 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $64.57 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $323.59 Typical High $331.13 | Professional | 54 · Surgery only | $239.88 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $302.00 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $223.87 | $302.00 | $309.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,344.23 Typical High $3,890.45 | Facility | 50 · Both sides | $891.25 | $2,344.23 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $776.25 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $295.12 | $776.25 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $794.33 Typical High $1,584.89 | Professional | 50 · Both sides | $588.84 | $794.33 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $263.03 Typical High $524.81 | Professional | 51 · Multiple procedures | $194.98 | $263.03 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $107.15 Typical High $208.93 | Professional | 80 · Assistant surgeon | $79.43 | $107.15 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $74.13 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $54.95 | $74.13 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $74.13 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $74.13 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $74.13 Typical High $147.91 | Professional | AS · PA/NP assist | $54.95 | $74.13 | $147.91 |
Where North Carolina sits
The same service costs 5.0 times more in Alaska 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· 14th of 51
$575
AK $1,622UT $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.