How much rates vary
Facilitymedian $166 · 10th to 90th $81 to $794Professionalmedian $269 · 10th to 90th $186 to $501
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 $190.55 Median $229.09 Typical High $7,413.10 | Facility | None | $190.55 | $229.09 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $257.04 | Professional | None | $190.55 | $229.09 | $257.04 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $512.86 | Professional | None | $204.17 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $204.17 Typical High $331.13 | Facility | None | $56.23 | $204.17 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $457.09 | Professional | None | $177.83 | $190.55 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $549.54 | Professional | None | $263.03 | $263.03 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $323.59 | Facility | None | $87.10 | $128.82 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $346.74 | Professional | None | $199.53 | $223.87 | $346.74 |
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 $158.49 Median $218.78 Typical High $512.86 | Professional | None | $158.49 | $218.78 | $512.86 |
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 $95.50 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $162.18 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $190.55 Typical High $467.74 | Facility | 50 · Both sides | $123.03 | $190.55 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $154.88 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $154.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $338.84 Typical High $870.96 | Professional | 50 · Both sides | $302.00 | $338.84 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $112.20 Typical High $288.40 | Professional | 51 · Multiple procedures | $100.00 | $112.20 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $44.67 Typical High $114.82 | Professional | 80 · Assistant surgeon | $39.81 | $44.67 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $31.62 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $28.18 | $31.62 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $31.62 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $31.62 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $31.62 Typical High $81.28 | Professional | AS · PA/NP assist | $28.18 | $31.62 | $81.28 |
Where North Carolina sits
The same service costs 5.0 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· 24th of 51
$269
AK $832FL $166
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.