How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $8,913Professionalmedian $1,622 · 10th to 90th $813 to $2,239
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 $758.58 Median $1,288.25 Typical High $8,317.64 | Facility | None | $758.58 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | None | $758.58 | $758.58 | $891.25 |
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 $1,023.29 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,621.81 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,905.46 | Professional | None | $912.01 | $1,122.02 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,621.81 | $1,621.81 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $5,248.07 | Facility | None | $588.84 | $1,412.54 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,380.38 | Professional | None | $912.01 | $1,047.13 | $1,380.38 |
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 $645.65 Median $933.25 Typical High $1,862.09 | Professional | None | $645.65 | $933.25 | $1,862.09 |
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 $380.19 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $602.56 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,137.96 Typical High $10,964.78 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,621.81 Typical High $2,818.38 | Professional | 50 · Both sides | $1,445.44 | $1,621.81 | $2,818.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $537.03 Typical High $933.25 | Professional | 51 · Multiple procedures | $478.63 | $537.03 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $213.80 Typical High $371.54 | Professional | 80 · Assistant surgeon | $194.98 | $213.80 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $151.36 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $134.90 | $151.36 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $151.36 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $151.36 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $263.03 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $263.03 |
Where North Carolina sits
The same service costs 7.6 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· 7th of 51
$1,622
AK $3,162TX $417
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.