How much rates vary
Facilitymedian $3,631 · 10th to 90th $891 to $10,965Professionalmedian $1,778 · 10th to 90th $933 to $2,455
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 $891.25 Median $1,445.44 Typical High $10,715.19 | Facility | None | $891.25 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $8,912.51 | Facility | None | $2,238.72 | $3,548.13 | $8,912.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,819.70 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $7,079.46 Typical High $10,232.93 | Facility | None | $912.01 | $7,079.46 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,023.29 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $7,413.10 | Facility | None | $831.76 | $1,778.28 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,096.48 | $1,659.59 |
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 $758.58 Median $977.24 Typical High $2,187.76 | Professional | None | $758.58 | $977.24 | $2,187.76 |
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 $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,630.27 Typical High $10,964.78 | Facility | 50 · Both sides | $1,258.93 | $2,630.27 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $891.25 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $416.87 | $891.25 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,659.59 Typical High $3,235.94 | Professional | 50 · Both sides | $1,621.81 | $1,659.59 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $549.54 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $549.54 | $549.54 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $218.78 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $218.78 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $154.88 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $151.36 | $154.88 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $154.88 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $154.88 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $154.88 Typical High $302.00 | Professional | AS · PA/NP assist | $151.36 | $154.88 | $302.00 |
Where North Carolina sits
The same service costs 7.9 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· 8th of 51
$1,820
AK $3,715TX $468
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.