How much rates vary
Facilitymedian $1,514 · 10th to 90th $603 to $3,981Professionalmedian $2,399 · 10th to 90th $1,479 to $4,074
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 $1,445.44 Median $1,513.56 Typical High $10,715.19 | Facility | None | $1,445.44 | $1,513.56 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,513.56 | $1,778.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,398.83 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,691.53 Typical High $3,235.94 | Facility | None | $912.01 | $2,691.53 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,513.56 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,137.96 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $3,388.44 | Facility | None | $758.58 | $1,148.15 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,737.80 | $2,454.71 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,715.35 | Professional | None | $1,258.93 | $1,621.81 | $3,715.35 |
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 $758.58 Median $758.58 Typical High $831.76 | Professional | 52 · Reduced service | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,174.90 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,479.11 Typical High $5,011.87 | Facility | 50 · Both sides | $1,096.48 | $1,479.11 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,630.27 Typical High $5,495.41 | Professional | 50 · Both sides | $2,454.71 | $2,630.27 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $870.96 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $831.76 | $870.96 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $346.74 Typical High $724.44 | Professional | 80 · Assistant surgeon | $331.13 | $346.74 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $245.47 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $229.09 | $245.47 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $245.47 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $245.47 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $245.47 Typical High $512.86 | Professional | AS · PA/NP assist | $229.09 | $245.47 | $512.86 |
Where North Carolina sits
The same service costs 15.8 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· 13th of 51
$2,399
AK $6,310TX $398
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.