How much rates vary
Facilitymedian $2,291 · 10th to 90th $661 to $5,888Professionalmedian $832 · 10th to 90th $537 to $1,778
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 $8,317.64 | Facility | None | $616.60 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | None | $616.60 | $616.60 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,778.28 | Professional | None | $537.03 | $1,023.29 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,513.56 | Professional | None | $645.65 | $676.08 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,445.44 | Professional | None | $954.99 | $954.99 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $2,398.83 | Facility | None | $602.56 | $1,047.13 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,023.29 | Professional | None | $691.83 | $741.31 | $1,023.29 |
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 $512.86 Median $660.69 Typical High $1,513.56 | Professional | None | $512.86 | $660.69 | $1,513.56 |
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 $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 $141.25 | Professional | 53 · Discontinued | $123.03 | $123.03 | $141.25 |
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 $891.25 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,122.02 Typical High $2,238.72 | Professional | 50 · Both sides | $1,047.13 | $1,122.02 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $371.54 Typical High $741.31 | Professional | 51 · Multiple procedures | $346.74 | $371.54 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $147.91 Typical High $302.00 | Professional | 80 · Assistant surgeon | $144.54 | $147.91 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $104.71 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $102.33 | $104.71 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $104.71 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $104.71 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $104.71 Typical High $208.93 | Professional | AS · PA/NP assist | $102.33 | $104.71 | $208.93 |
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· 22nd of 51
$891
AK $2,570TX $331
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.