How much rates vary
Facilitymedian $447 · 10th to 90th $120 to $1,698Professionalmedian $589 · 10th to 90th $398 to $1,148
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 $389.05 Median $426.58 Typical High $7,413.10 | Facility | None | $389.05 | $426.58 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $478.63 | Professional | None | $389.05 | $426.58 | $478.63 |
BCBS North Carolina Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $537.03 | Facility | None | $269.15 | $398.11 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,148.15 | Professional | None | $489.78 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,737.80 | Facility | None | $457.09 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $977.24 | Professional | None | $389.05 | $436.52 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,023.29 | Professional | None | $630.96 | $630.96 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $1,548.82 | Facility | None | $263.03 | $489.78 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $724.44 | Professional | None | $416.87 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $977.24 | Professional | None | $338.84 | $436.52 | $977.24 |
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 $194.98 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $316.23 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $371.54 Median $676.08 Typical High $2,818.38 | Facility | 50 · Both sides | $371.54 | $676.08 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $123.03 Median $223.87 Typical High $933.25 | Facility | 51 · Multiple procedures | $123.03 | $223.87 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $724.44 Typical High $1,584.89 | Professional | 50 · Both sides | $616.60 | $724.44 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $245.47 Typical High $524.81 | Professional | 51 · Multiple procedures | $208.93 | $245.47 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $208.93 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $147.91 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $147.91 |
Where North Carolina sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 17th of 51
$589
AK $1,738UT $324
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.