How much rates vary
Facilitymedian $4,786 · 10th to 90th $741 to $17,783Professionalmedian $1,202 · 10th to 90th $617 to $2,344
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 $851.14 Median $1,258.93 Typical High $8,317.64 | Facility | None | $851.14 | $1,258.93 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | None | $851.14 | $851.14 | $1,000.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,585.78 Typical High $19,054.61 | Facility | None | $4,786.30 | $7,585.78 | $19,054.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $616.60 Median $1,513.56 Typical High $2,511.89 | Professional | None | $616.60 | $1,513.56 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $12,022.64 Typical High $17,782.79 | Facility | None | $645.65 | $12,022.64 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $2,137.96 | Professional | None | $977.24 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,479.11 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $14,454.40 | Facility | None | $602.56 | $1,584.89 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,202.26 | $1,412.54 |
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 $724.44 Median $954.99 Typical High $2,089.30 | Professional | None | $724.44 | $954.99 | $2,089.30 |
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 $426.58 Median $426.58 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $5,370.32 Typical High $30,199.52 | Facility | 50 · Both sides | $891.25 | $5,370.32 | $30,199.52 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,819.70 Typical High $10,000.00 | Facility | 51 · Multiple procedures | $295.12 | $1,819.70 | $10,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,819.70 Typical High $3,090.30 | Professional | 50 · Both sides | $1,584.89 | $1,819.70 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $602.56 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $537.03 | $602.56 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $239.88 Typical High $407.38 | Professional | 80 · Assistant surgeon | $213.80 | $239.88 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $169.82 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $147.91 | $169.82 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $169.82 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $169.82 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $169.82 Typical High $288.40 | Professional | AS · PA/NP assist | $147.91 | $169.82 | $288.40 |
Where North Carolina sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $19,036HI $2,542
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.