How much rates vary
Facilitymedian $1,738 · 10th to 90th $490 to $5,129Professionalmedian $603 · 10th to 90th $407 to $1,175
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 $407.38 Median $1,000.00 Typical High $7,943.28 | Facility | None | $407.38 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | None | $407.38 | $407.38 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,202.26 | Professional | None | $457.09 | $707.95 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,235.94 | Facility | None | $457.09 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $1,000.00 | Professional | None | $436.52 | $457.09 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | None | $645.65 | $645.65 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $2,398.83 | Facility | None | $380.19 | $776.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $691.83 | Professional | None | $478.63 | $524.81 | $691.83 |
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 $346.74 Median $457.09 Typical High $1,047.13 | Professional | None | $346.74 | $457.09 | $1,047.13 |
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 $204.17 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,445.44 Typical High $5,011.87 | Facility | 50 · Both sides | $562.34 | $1,445.44 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $478.63 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $186.21 | $478.63 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $794.33 Typical High $1,513.56 | Professional | 50 · Both sides | $707.95 | $794.33 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $263.03 Typical High $501.19 | Professional | 51 · Multiple procedures | $234.42 | $263.03 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $104.71 Typical High $204.17 | Professional | 80 · Assistant surgeon | $97.72 | $104.71 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $74.13 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $69.18 | $74.13 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $74.13 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $74.13 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $74.13 Typical High $141.25 | Professional | AS · PA/NP assist | $69.18 | $74.13 | $141.25 |
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· 21st of 51
$646
AK $1,738TX $209
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.