How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,000 to $11,220Professionalmedian $2,399 · 10th to 90th $1,230 to $3,388
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 $1,148.15 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,148.15 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,148.15 | $1,318.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $6,918.31 Typical High $9,549.93 | Facility | None | $4,786.30 | $6,918.31 | $9,549.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,513.56 | $2,511.89 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,918.31 Typical High $10,232.93 | Facility | None | $794.33 | $6,918.31 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,584.89 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,344.23 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $3,630.78 Typical High $7,585.78 | Facility | None | $741.31 | $3,630.78 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,659.59 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,818.38 | Professional | None | $977.24 | $1,412.54 | $2,818.38 |
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 $575.44 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $912.01 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $5,370.32 Typical High $15,488.17 | Facility | 50 · Both sides | $1,096.48 | $5,370.32 | $15,488.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,819.70 Typical High $5,128.61 | Facility | 51 · Multiple procedures | $363.08 | $1,819.70 | $5,128.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,754.23 Typical High $4,168.69 | Professional | 50 · Both sides | $2,238.72 | $2,754.23 | $4,168.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $371.54 Typical High $549.54 | Professional | 80 · Assistant surgeon | $302.00 | $371.54 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $257.04 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $208.93 | $257.04 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $257.04 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $257.04 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $389.05 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $389.05 |
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· 7th of 51
$2,512
AK $4,786TX $575
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.