How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,023 to $18,197Professionalmedian $1,479 · 10th to 90th $891 to $2,884
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 $1,047.13 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,047.13 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,047.13 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $6,456.54 | Facility | None | $3,235.94 | $4,786.30 | $6,456.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $2,884.03 | Professional | None | $891.25 | $1,698.24 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $13,182.57 Typical High $19,054.61 | Facility | None | $912.01 | $13,182.57 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $16,982.44 | Facility | None | $831.76 | $2,754.23 | $16,982.44 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,348.96 | $1,698.24 |
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 $891.25 Median $1,148.15 Typical High $2,570.40 | Professional | None | $891.25 | $1,148.15 | $2,570.40 |
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 $524.81 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $831.76 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $4,073.80 Typical High $33,113.11 | Facility | 50 · Both sides | $1,258.93 | $4,073.80 | $33,113.11 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,380.38 Typical High $10,964.78 | Facility | 51 · Multiple procedures | $416.87 | $1,380.38 | $10,964.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,041.74 Typical High $3,801.89 | Professional | 50 · Both sides | $1,949.84 | $2,041.74 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $676.08 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $645.65 | $676.08 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $269.15 Typical High $501.19 | Professional | 80 · Assistant surgeon | $263.03 | $269.15 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $190.55 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $181.97 | $190.55 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $190.55 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $190.55 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $190.55 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $190.55 | $354.81 |
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· 22nd of 51
$1,549
AK $4,365TX $550
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.