How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,000 to $18,621Professionalmedian $2,089 · 10th to 90th $1,259 to $3,388
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 $1,230.27 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,230.27 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $9,120.11 | Facility | None | $3,548.13 | $5,754.40 | $9,120.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,137.96 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $13,182.57 Typical High $19,054.61 | Facility | None | $794.33 | $13,182.57 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,380.38 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,949.84 | $1,949.84 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $3,630.78 Typical High $18,620.87 | Facility | None | $741.31 | $3,630.78 | $18,620.87 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,513.56 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,348.96 | $3,090.30 |
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 $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $977.24 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $5,370.32 Typical High $28,183.83 | Facility | 50 · Both sides | $1,096.48 | $5,370.32 | $28,183.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,819.70 Typical High $9,332.54 | Facility | 51 · Multiple procedures | $363.08 | $1,819.70 | $9,332.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,290.87 Typical High $4,466.84 | Professional | 50 · Both sides | $2,089.30 | $2,290.87 | $4,466.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $758.58 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $691.83 | $758.58 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $302.00 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $302.00 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $213.80 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $194.98 | $213.80 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $213.80 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $213.80 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $213.80 Typical High $416.87 | Professional | AS · PA/NP assist | $194.98 | $213.80 | $416.87 |
Where North Carolina sits
The same service costs 7.6 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· 12th of 51
$2,089
AK $5,129TX $676
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.