How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $4,571Professionalmedian $977 · 10th to 90th $575 to $1,738
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 $588.84 Median $1,288.25 Typical High $8,317.64 | Facility | None | $588.84 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $1,122.02 Typical High $1,737.80 | Professional | None | $575.44 | $1,122.02 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,089.30 | Facility | None | $645.65 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,445.44 | Professional | None | $707.95 | $912.01 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,288.25 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,905.46 | Facility | None | $588.84 | $1,000.00 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,148.15 | Professional | None | $707.95 | $812.83 | $1,148.15 |
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 $501.19 Median $724.44 Typical High $1,479.11 | Professional | None | $501.19 | $724.44 | $1,479.11 |
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 $295.12 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $467.74 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,584.89 Typical High $2,818.38 | Facility | 50 · Both sides | $891.25 | $1,584.89 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $524.81 Typical High $933.25 | Facility | 51 · Multiple procedures | $295.12 | $524.81 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,288.25 Typical High $2,344.23 | Professional | 50 · Both sides | $1,122.02 | $1,288.25 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $426.58 Typical High $776.25 | Professional | 51 · Multiple procedures | $371.54 | $426.58 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $169.82 Typical High $316.23 | Professional | 80 · Assistant surgeon | $154.88 | $169.82 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $120.23 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $107.15 | $120.23 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $120.23 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $120.23 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $120.23 Typical High $218.78 | Professional | AS · PA/NP assist | $107.15 | $120.23 | $218.78 |
Where North Carolina sits
The same service costs 7.4 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· 14th of 51
$1,023
AK $2,455TX $331
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.