How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $8,913Professionalmedian $1,820 · 10th to 90th $1,047 to $2,884
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 $1,000.00 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,000.00 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,000.00 | $1,148.15 |
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 $1,318.26 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,905.46 | $2,951.21 |
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 $1,202.26 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,380.38 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,995.26 | $1,995.26 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $4,677.35 | Facility | None | $588.84 | $1,412.54 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,412.54 | $1,659.59 |
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 $851.14 Median $1,230.27 Typical High $2,454.71 | Professional | None | $851.14 | $1,230.27 | $2,454.71 |
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 $501.19 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $776.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,137.96 Typical High $7,413.10 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $7,413.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $2,511.89 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $2,511.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,344.23 Typical High $3,630.78 | Professional | 50 · Both sides | $1,949.84 | $2,344.23 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $776.25 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $645.65 | $776.25 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $316.23 Typical High $478.63 | Professional | 80 · Assistant surgeon | $257.04 | $316.23 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $218.78 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $181.97 | $218.78 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $218.78 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $218.78 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $338.84 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $338.84 |
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· 12th of 51
$1,820
AK $4,169TX $501
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.