How much rates vary
Facilitymedian $4,266 · 10th to 90th $741 to $14,125Professionalmedian $1,413 · 10th to 90th $977 to $2,630
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 $891.25 Median $1,288.25 Typical High $8,317.64 | Facility | None | $891.25 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,585.78 Typical High $19,054.61 | Facility | None | $4,786.30 | $7,585.78 | $19,054.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,000.00 | $1,698.24 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $9,120.11 Typical High $13,489.63 | Facility | None | $645.65 | $9,120.11 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,288.25 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,862.09 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $10,715.19 | Facility | None | $588.84 | $2,089.30 | $10,715.19 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,230.27 | $1,513.56 |
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 $776.25 Median $1,122.02 Typical High $2,238.72 | Professional | None | $776.25 | $1,122.02 | $2,238.72 |
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 $446.68 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $724.44 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $5,370.32 Typical High $21,379.62 | Facility | 50 · Both sides | $891.25 | $5,370.32 | $21,379.62 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,819.70 Typical High $7,079.46 | Facility | 51 · Multiple procedures | $295.12 | $1,819.70 | $7,079.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,041.74 Typical High $3,235.94 | Professional | 50 · Both sides | $1,737.80 | $2,041.74 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $676.08 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $588.84 | $676.08 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $269.15 Typical High $436.52 | Professional | 80 · Assistant surgeon | $234.42 | $269.15 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $190.55 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $162.18 | $190.55 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $190.55 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $190.55 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $302.00 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $302.00 |
Where North Carolina sits
The same service costs 7.9 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· 14th of 51
$1,514
AK $3,715TX $468
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.