How much rates vary
Facilitymedian $1,000 · 10th to 90th $324 to $3,311Professionalmedian $339 · 10th to 90th $229 to $661
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 $234.42 Median $234.42 Typical High $7,413.10 | Facility | None | $234.42 | $234.42 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | None | $234.42 | $234.42 | $275.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $1,096.48 | Facility | None | $275.42 | $426.58 | $1,096.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $660.69 | Professional | None | $269.15 | $389.05 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,737.80 | Facility | None | $457.09 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $549.54 | Professional | None | $223.87 | $239.88 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | None | $331.13 | $331.13 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $416.87 Typical High $1,288.25 | Facility | None | $245.47 | $416.87 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $398.11 | Professional | None | $229.09 | $263.03 | $398.11 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $602.56 | Professional | None | $194.98 | $245.47 | $602.56 |
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 $117.49 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $46.77 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $173.78 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $26.30 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $162.18 | $165.96 | $181.97 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $371.54 Median $691.83 Typical High $2,818.38 | Facility | 50 · Both sides | $371.54 | $691.83 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $123.03 Median $229.09 Typical High $933.25 | Facility | 51 · Multiple procedures | $123.03 | $229.09 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $389.05 Typical High $891.25 | Professional | 50 · Both sides | $346.74 | $389.05 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $131.83 Typical High $295.12 | Professional | 51 · Multiple procedures | $114.82 | $131.83 | $295.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $52.48 Typical High $117.49 | Professional | 80 · Assistant surgeon | $46.77 | $52.48 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $36.31 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $32.36 | $36.31 | $83.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $32.36 Median $36.31 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $32.36 | $36.31 | $83.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $36.31 Typical High $83.18 | Professional | AS · PA/NP assist | $32.36 | $36.31 | $83.18 |
Where North Carolina sits
The same service costs 5.4 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· 19th of 51
$347
AK $1,023UT $191
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.