How much rates vary
Facilitymedian $2,399 · 10th to 90th $912 to $5,888Professionalmedian $1,660 · 10th to 90th $1,122 to $3,090
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 $1,122.02 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,122.02 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,905.46 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,288.25 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,905.46 | $1,905.46 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $3,388.44 | Facility | None | $741.31 | $1,412.54 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,513.56 | $1,862.09 |
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 $977.24 Median $1,258.93 Typical High $2,754.23 | Professional | None | $977.24 | $1,258.93 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $223.87 | $257.04 |
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 $112.20 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $128.82 |
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 $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $1,096.48 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,511.89 Typical High $4,073.80 | Professional | 50 · Both sides | $2,089.30 | $2,511.89 | $4,073.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $831.76 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $691.83 | $831.76 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $331.13 Typical High $537.03 | Professional | 80 · Assistant surgeon | $275.42 | $331.13 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $234.42 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $194.98 | $234.42 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $234.42 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $234.42 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $380.19 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $380.19 |
Where North Carolina sits
The same service costs 7.9 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· 22nd of 51
$1,660
AK $4,571TX $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.