How much rates vary
Facilitymedian $126 · 10th to 90th $79 to $794Professionalmedian $166 · 10th to 90th $110 to $324
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 $95.50 Median $109.65 Typical High $7,413.10 | Facility | None | $95.50 | $109.65 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $169.82 | Professional | None | $95.50 | $109.65 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $138.04 | Facility | None | $69.18 | $102.33 | $138.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $323.59 | Professional | None | $138.04 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $134.90 Typical High $204.17 | Facility | None | $56.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $302.00 | Professional | None | $112.20 | $123.03 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $263.03 | Professional | None | $162.18 | $162.18 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $204.17 | Facility | None | $87.10 | $128.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $194.98 | Professional | None | $123.03 | $134.90 | $194.98 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $263.03 | Professional | None | $89.13 | $117.49 | $263.03 |
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 $47.86 Median $54.95 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.88 Typical High $23.44 | Professional | 53 · Discontinued | $19.05 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $89.13 | Professional | 54 · Surgery only | $72.44 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $17.78 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $77.62 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $67.61 | $77.62 | $83.18 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $190.55 Typical High $309.03 | Facility | 50 · Both sides | $123.03 | $190.55 | $309.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $102.33 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $102.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $234.42 Typical High $436.52 | Professional | 50 · Both sides | $181.97 | $234.42 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $77.62 Typical High $144.54 | Professional | 51 · Multiple procedures | $61.66 | $77.62 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $30.90 Typical High $57.54 | Professional | 80 · Assistant surgeon | $24.55 | $30.90 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $21.88 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $16.98 | $21.88 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $21.88 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $21.88 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $21.88 Typical High $40.74 | Professional | AS · PA/NP assist | $16.98 | $21.88 | $40.74 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 14th of 51
$166
AK $427FL $95.50
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.