How much rates vary
Facilitymedian $1,318 · 10th to 90th $363 to $3,236Professionalmedian $550 · 10th to 90th $251 to $1,122
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 $398.11 Median $1,000.00 Typical High $7,943.28 | Facility | None | $398.11 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | None | $398.11 | $398.11 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,041.74 | Facility | None | $1,000.00 | $1,513.56 | $2,041.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $251.19 Median $630.96 Typical High $1,148.15 | Professional | None | $251.19 | $630.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,235.94 | Facility | None | $457.09 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $954.99 | Professional | None | $407.38 | $436.52 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $2,398.83 | Facility | None | $380.19 | $537.03 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $676.08 | Professional | None | $436.52 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,023.29 | Professional | None | $338.84 | $436.52 | $1,023.29 |
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 $199.53 Median $199.53 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $316.23 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $794.33 Typical High $5,011.87 | Facility | 50 · Both sides | $562.34 | $794.33 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $269.15 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $186.21 | $269.15 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $741.31 Typical High $1,479.11 | Professional | 50 · Both sides | $660.69 | $741.31 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $245.47 Typical High $501.19 | Professional | 51 · Multiple procedures | $218.78 | $245.47 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $97.72 Typical High $199.53 | Professional | 80 · Assistant surgeon | $91.20 | $97.72 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $69.18 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $64.57 | $69.18 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $69.18 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $69.18 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $69.18 Typical High $138.04 | Professional | AS · PA/NP assist | $64.57 | $69.18 | $138.04 |
Where North Carolina sits
The same service costs 8.1 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· 24th of 51
$562
AK $1,698TX $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.