How much rates vary
Facilitymedian $2,399 · 10th to 90th $741 to $9,120Professionalmedian $1,230 · 10th to 90th $813 to $2,188
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 $870.96 | Professional | None | $758.58 | $758.58 | $870.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $10,232.93 | Facility | None | $2,570.40 | $4,073.80 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,445.44 | $2,238.72 |
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 $912.01 Median $1,122.02 Typical High $1,862.09 | Professional | None | $912.01 | $1,122.02 | $1,862.09 |
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 $1,778.28 Typical High $3,388.44 | Facility | None | $588.84 | $1,778.28 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,348.96 | Professional | None | $912.01 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
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 $371.54 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $151.36 | $169.82 |
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 $85.11 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $85.11 |
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 $2,818.38 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $2,818.38 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $954.99 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $954.99 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,754.23 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | 51 · Multiple procedures | $489.78 | $575.44 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $229.09 Typical High $363.08 | Professional | 80 · Assistant surgeon | $199.53 | $229.09 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $138.04 | $162.18 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $162.18 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $257.04 |
Where North Carolina sits
The same service costs 8.3 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· 18th of 51
$1,259
AK $3,162TX $380
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.