How much rates vary
Facilitymedian $4,677 · 10th to 90th $708 to $10,471Professionalmedian $1,000 · 10th to 90th $741 to $2,042
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 $707.95 Median $1,288.25 Typical High $8,317.64 | Facility | None | $707.95 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $6,918.31 Typical High $9,549.93 | Facility | None | $4,786.30 | $6,918.31 | $9,549.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,041.74 | Professional | None | $812.83 | $1,202.26 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,737.80 | Professional | None | $794.33 | $812.83 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $4,677.35 | Facility | None | $602.56 | $1,318.26 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,174.90 | Professional | None | $851.14 | $912.01 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,737.80 | Professional | None | $602.56 | $776.25 | $1,737.80 |
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 $354.81 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $562.34 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $5,011.87 Typical High $7,413.10 | Facility | 50 · Both sides | $891.25 | $5,011.87 | $7,413.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,698.24 Typical High $2,511.89 | Facility | 51 · Multiple procedures | $295.12 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,348.96 Typical High $2,570.40 | Professional | 50 · Both sides | $1,318.26 | $1,348.96 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $457.09 Typical High $851.14 | Professional | 51 · Multiple procedures | $436.52 | $457.09 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $181.97 Typical High $346.74 | Professional | 80 · Assistant surgeon | $173.78 | $181.97 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $125.89 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $123.03 | $125.89 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $125.89 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $125.89 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $125.89 Typical High $239.88 | Professional | AS · PA/NP assist | $123.03 | $125.89 | $239.88 |
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
$1,072
AK $2,951TX $380
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.