How much rates vary
Facilitymedian $2,512 · 10th to 90th $741 to $8,318Professionalmedian $1,230 · 10th to 90th $631 to $1,698
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 $616.60 Median $1,288.25 Typical High $10,471.29 | Facility | None | $616.60 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $5,623.41 | Facility | None | $1,412.54 | $2,238.72 | $5,623.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $1,778.28 | Professional | None | $794.33 | $1,479.11 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,513.56 | Professional | None | $676.08 | $707.95 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,047.13 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $7,244.36 | Facility | None | $724.44 | $1,174.90 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,023.29 | Professional | None | $741.31 | $812.83 | $1,023.29 |
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 $524.81 Median $676.08 Typical High $1,548.82 | Professional | None | $524.81 | $676.08 | $1,548.82 |
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 $309.03 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $489.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,230.27 Typical High $2,238.72 | Professional | 50 · Both sides | $1,122.02 | $1,230.27 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $407.38 Typical High $758.58 | Professional | 51 · Multiple procedures | $380.19 | $407.38 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $162.18 Typical High $302.00 | Professional | 80 · Assistant surgeon | $151.36 | $162.18 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $114.82 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $104.71 | $114.82 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $114.82 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $114.82 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $114.82 Typical High $208.93 | Professional | AS · PA/NP assist | $104.71 | $114.82 | $208.93 |
Where North Carolina sits
The same service costs 8.3 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· 11th of 51
$1,230
AK $2,570TX $309
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.