How much rates vary
Facilitymedian $2,188 · 10th to 90th $708 to $6,918Professionalmedian $2,818 · 10th to 90th $1,622 to $4,467
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 $1,621.81 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,621.81 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,621.81 | $1,905.46 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $6,309.57 | Facility | None | $1,584.89 | $2,454.71 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,818.38 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,235.94 | Facility | None | $602.56 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $3,981.07 | Professional | None | $1,737.80 | $1,819.70 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,570.40 | $2,570.40 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,258.93 Typical High $3,388.44 | Facility | None | $549.54 | $1,258.93 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,862.09 | $2,089.30 | $2,691.53 |
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 $1,380.38 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,778.28 | $3,981.07 |
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 $812.83 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $812.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,288.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,905.46 Typical High $5,011.87 | Facility | 50 · Both sides | $776.25 | $1,905.46 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $630.96 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $263.03 | $630.96 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,162.28 Typical High $5,754.40 | Professional | 50 · Both sides | $2,818.38 | $3,162.28 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,071.52 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $933.25 | $1,071.52 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $426.58 Typical High $776.25 | Professional | 80 · Assistant surgeon | $371.54 | $426.58 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $295.12 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $263.03 | $295.12 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $295.12 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $295.12 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $295.12 Typical High $537.03 | Professional | AS · PA/NP assist | $263.03 | $295.12 | $537.03 |
Where North Carolina sits
The same service costs 7.8 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· 11th of 51
$2,818
AK $6,761TX $871
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.