How much rates vary
Facilitymedian $4,365 · 10th to 90th $955 to $9,772Professionalmedian $1,549 · 10th to 90th $1,000 to $2,630
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 $954.99 Median $1,288.25 Typical High $10,471.29 | Facility | None | $954.99 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | None | $954.99 | $954.99 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,888.44 Typical High $9,120.11 | Facility | None | $3,548.13 | $5,888.44 | $9,120.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,659.59 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,096.48 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,621.81 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $3,630.78 Typical High $5,248.07 | Facility | None | $741.31 | $3,630.78 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,344.23 | Professional | None | $812.83 | $1,047.13 | $2,344.23 |
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 $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $758.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $5,370.32 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $5,370.32 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,819.70 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $1,819.70 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,862.09 Typical High $3,467.37 | Professional | 50 · Both sides | $1,778.28 | $1,862.09 | $3,467.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $616.60 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $588.84 | $616.60 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $251.19 Typical High $457.09 | Professional | 80 · Assistant surgeon | $234.42 | $251.19 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $173.78 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $165.96 | $173.78 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $173.78 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $173.78 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $173.78 Typical High $323.59 | Professional | AS · PA/NP assist | $165.96 | $173.78 | $323.59 |
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· 19th of 51
$1,549
AK $3,981TX $501
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.