How much rates vary
Facilitymedian $2,951 · 10th to 90th $955 to $10,471Professionalmedian $1,445 · 10th to 90th $912 to $2,818
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 $1,023.29 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,023.29 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,023.29 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $2,951.21 | Professional | None | $912.01 | $1,737.80 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $7,079.46 Typical High $10,471.29 | Facility | None | $912.01 | $7,079.46 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,174.90 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,659.59 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $5,248.07 | Facility | None | $831.76 | $1,412.54 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,380.38 | $1,659.59 |
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 $870.96 Median $1,122.02 Typical High $2,511.89 | Professional | None | $870.96 | $1,122.02 | $2,511.89 |
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 $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,137.96 Typical High $10,964.78 | Facility | 50 · Both sides | $1,258.93 | $2,137.96 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $707.95 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $416.87 | $707.95 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,137.96 Typical High $3,715.35 | Professional | 50 · Both sides | $1,905.46 | $2,137.96 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $707.95 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $630.96 | $707.95 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $281.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $251.19 | $281.84 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $199.53 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $177.83 | $199.53 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $199.53 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $199.53 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $199.53 Typical High $346.74 | Professional | AS · PA/NP assist | $177.83 | $199.53 | $346.74 |
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· 23rd of 51
$1,445
AK $4,266TX $537
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.