How much rates vary
Facilitymedian $2,089 · 10th to 90th $676 to $6,761Professionalmedian $1,023 · 10th to 90th $692 to $1,905
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 $676.08 Median $1,288.25 Typical High $8,317.64 | Facility | None | $676.08 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,691.53 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,905.46 | Professional | None | $812.83 | $1,096.48 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $4,265.80 | Facility | None | $645.65 | $2,884.03 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,621.81 | Professional | None | $707.95 | $758.58 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,047.13 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,818.38 | Facility | None | $602.56 | $1,202.26 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,122.02 | Professional | None | $776.25 | $870.96 | $1,122.02 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,698.24 | Professional | None | $575.44 | $741.31 | $1,698.24 |
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 $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $549.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,380.38 Typical High $2,511.89 | Professional | 50 · Both sides | $1,148.15 | $1,380.38 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $457.09 Typical High $831.76 | Professional | 51 · Multiple procedures | $389.05 | $457.09 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $331.13 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $234.42 |
Where North Carolina sits
The same service costs 8.5 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· 21st of 51
$1,023
AK $2,884TX $339
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.