How much rates vary
Facilitymedian $2,818 · 10th to 90th $933 to $7,413Professionalmedian $1,445 · 10th to 90th $1,000 to $2,692
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 $933.25 Median $1,288.25 Typical High $10,471.29 | Facility | None | $933.25 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | None | $933.25 | $933.25 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,715.35 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,698.24 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,348.96 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,949.84 | $1,949.84 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,905.46 Typical High $3,388.44 | Facility | None | $741.31 | $1,905.46 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,348.96 | $1,584.89 |
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 $794.33 Median $1,148.15 Typical High $2,344.23 | Professional | None | $794.33 | $1,148.15 | $2,344.23 |
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 $467.74 Median $467.74 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $758.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,818.38 Typical High $5,011.87 | Facility | 50 · Both sides | $1,096.48 | $2,818.38 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $954.99 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $954.99 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,290.87 Typical High $3,388.44 | Professional | 50 · Both sides | $1,737.80 | $2,290.87 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $575.44 | $776.25 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $229.09 | $309.03 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $218.78 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $162.18 | $218.78 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $218.78 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $218.78 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $218.78 Typical High $316.23 | Professional | AS · PA/NP assist | $162.18 | $218.78 | $316.23 |
Where North Carolina sits
The same service costs 16.2 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· 19th of 51
$1,549
AK $3,890TX $240
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.