How much rates vary
Facilitymedian $2,951 · 10th to 90th $851 to $9,550Professionalmedian $977 · 10th to 90th $692 to $1,862
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 $660.69 Median $1,445.44 Typical High $10,715.19 | Facility | None | $660.69 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | None | $660.69 | $660.69 | $776.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,691.53 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,949.84 | Professional | None | $851.14 | $1,148.15 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $5,011.87 Typical High $7,413.10 | Facility | None | $912.01 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,659.59 | Professional | None | $741.31 | $758.58 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,122.02 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $7,413.10 | Facility | None | $831.76 | $1,412.54 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,096.48 | Professional | None | $794.33 | $891.25 | $1,096.48 |
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 $562.34 Median $741.31 Typical High $1,659.59 | Professional | None | $562.34 | $741.31 | $1,659.59 |
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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $537.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,137.96 Typical High $10,964.78 | Facility | 50 · Both sides | $1,258.93 | $2,137.96 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $707.95 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $416.87 | $707.95 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,412.54 Typical High $2,454.71 | Professional | 50 · Both sides | $1,230.27 | $1,412.54 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | 51 · Multiple procedures | $407.38 | $478.63 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $323.59 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $131.83 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $114.82 | $131.83 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $131.83 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $131.83 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $131.83 Typical High $229.09 | Professional | AS · PA/NP assist | $114.82 | $131.83 | $229.09 |
Where North Carolina sits
The same service costs 7.8 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
$977
AK $2,818TX $363
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.