How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,202 to $10,233Professionalmedian $1,380 · 10th to 90th $646 to $3,631
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 $1,288.25 Median $1,318.26 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,318.26 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,715.35 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $1,445.44 Typical High $3,715.35 | Professional | None | $645.65 | $1,445.44 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,918.31 Typical High $11,748.98 | Facility | None | $602.56 | $6,918.31 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $2,951.21 | Professional | None | $794.33 | $933.25 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,445.44 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $5,248.07 | Facility | None | $2,089.30 | $3,311.31 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,187.76 | Professional | None | $977.24 | $1,445.44 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,235.94 | Professional | None | $812.83 | $1,318.26 | $3,235.94 |
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 $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,047.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,162.28 Median $4,897.79 Typical High $10,964.78 | Facility | 50 · Both sides | $3,162.28 | $4,897.79 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,659.59 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $1,047.13 | $1,659.59 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,187.76 Typical High $4,786.30 | Professional | 50 · Both sides | $1,479.11 | $2,187.76 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $724.44 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $489.78 | $724.44 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $288.40 Typical High $630.96 | Professional | 80 · Assistant surgeon | $194.98 | $288.40 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $204.17 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $138.04 | $204.17 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $204.17 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $204.17 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $204.17 Typical High $446.68 | Professional | AS · PA/NP assist | $138.04 | $204.17 | $446.68 |
Where North Carolina sits
The same service costs 8.9 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· 33rd of 51
$1,445
AK $5,495TX $617
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.