How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $6,918Professionalmedian $1,288 · 10th to 90th $646 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 $1,047.13 Typical High $8,317.64 | Facility | None | $588.84 | $1,047.13 | $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 $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,737.80 | Professional | None | $831.76 | $1,380.38 | $1,737.80 |
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 $724.44 Median $933.25 Typical High $1,479.11 | Professional | None | $724.44 | $933.25 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,318.26 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $3,019.95 | Facility | None | $588.84 | $1,412.54 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,122.02 | Professional | None | $707.95 | $812.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
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 $134.90 | Professional | 53 · Discontinued | $117.49 | $117.49 | $134.90 |
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 $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $67.61 |
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 $2,137.96 Typical High $7,079.46 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $7,079.46 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $2,344.23 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,288.25 Typical High $2,290.87 | Professional | 50 · Both sides | $1,122.02 | $1,288.25 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $426.58 Typical High $776.25 | Professional | 51 · Multiple procedures | $380.19 | $426.58 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $169.82 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $169.82 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $120.23 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $107.15 | $120.23 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $120.23 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $120.23 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $120.23 Typical High $213.80 | Professional | AS · PA/NP assist | $107.15 | $120.23 | $213.80 |
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· 6th of 51
$1,318
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.