How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $5,248Professionalmedian $794 · 10th to 90th $525 to $1,514
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 $562.34 Median $1,288.25 Typical High $8,317.64 | Facility | None | $562.34 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,584.89 | Professional | None | $524.81 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,318.26 | Professional | None | $588.84 | $616.60 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $2,398.83 | Facility | None | $588.84 | $954.99 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $933.25 | Professional | None | $660.69 | $724.44 | $933.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,412.54 | Professional | None | $467.74 | $616.60 | $1,412.54 |
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 $281.84 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $446.68 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,174.90 Typical High $2,041.74 | Professional | 50 · Both sides | $1,023.29 | $1,174.90 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $389.05 Typical High $676.08 | Professional | 51 · Multiple procedures | $338.84 | $389.05 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $275.42 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $109.65 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $95.50 | $109.65 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $109.65 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $109.65 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $109.65 Typical High $190.55 | Professional | AS · PA/NP assist | $95.50 | $109.65 | $190.55 |
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· 24th of 51
$813
AK $2,344TX $263
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.