How much rates vary
Facilitymedian $3,981 · 10th to 90th $851 to $14,125Professionalmedian $1,175 · 10th to 90th $813 to $2,239
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 $812.83 Median $1,445.44 Typical High $10,715.19 | Facility | None | $812.83 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $3,630.78 Typical High $8,912.51 | Facility | None | $2,238.72 | $3,630.78 | $8,912.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,348.96 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $9,332.54 Typical High $13,489.63 | Facility | None | $912.01 | $9,332.54 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,995.26 | Professional | None | $831.76 | $870.96 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,258.93 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $10,715.19 | Facility | None | $831.76 | $1,778.28 | $10,715.19 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,348.96 | Professional | None | $891.25 | $977.24 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,467.37 | $15,848.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,995.26 | Professional | None | $691.83 | $891.25 | $1,995.26 |
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 $407.38 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $645.65 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,630.27 Typical High $21,379.62 | Facility | 50 · Both sides | $1,258.93 | $2,630.27 | $21,379.62 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $891.25 Typical High $7,079.46 | Facility | 51 · Multiple procedures | $416.87 | $891.25 | $7,079.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,479.11 Typical High $2,951.21 | Professional | 50 · Both sides | $1,318.26 | $1,479.11 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $489.78 Typical High $977.24 | Professional | 51 · Multiple procedures | $446.68 | $489.78 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $194.98 Typical High $389.05 | Professional | 80 · Assistant surgeon | $177.83 | $194.98 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $138.04 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $123.03 | $138.04 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $138.04 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $138.04 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $138.04 Typical High $275.42 | Professional | AS · PA/NP assist | $123.03 | $138.04 | $275.42 |
Where North Carolina sits
The same service costs 16.2 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
$1,175
AK $3,388TX $209
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.