How much rates vary
Facilitymedian $2,630 · 10th to 90th $692 to $7,943Professionalmedian $1,318 · 10th to 90th $708 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 $691.83 Median $1,288.25 Typical High $8,317.64 | Facility | None | $691.83 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,174.90 | Professional | None | $691.83 | $691.83 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,949.84 | Professional | None | $831.76 | $1,318.26 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,698.24 | Professional | None | $724.44 | $776.25 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,096.48 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $4,677.35 | Facility | None | $602.56 | $1,202.26 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,148.15 | Professional | None | $812.83 | $891.25 | $1,148.15 |
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 $588.84 Median $758.58 Typical High $1,698.24 | Professional | None | $588.84 | $758.58 | $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 $346.74 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $138.04 | $158.49 |
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 $69.18 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $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 $7,413.10 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $7,413.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $2,511.89 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $2,511.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,348.96 Typical High $2,511.89 | Professional | 50 · Both sides | $1,230.27 | $1,348.96 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $446.68 Typical High $831.76 | Professional | 51 · Multiple procedures | $407.38 | $446.68 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $177.83 Typical High $338.84 | Professional | 80 · Assistant surgeon | $162.18 | $177.83 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $125.89 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $114.82 | $125.89 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $125.89 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $125.89 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $125.89 Typical High $234.42 | Professional | AS · PA/NP assist | $114.82 | $125.89 | $234.42 |
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· 11th of 51
$1,318
AK $2,884TX $363
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.