How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $6,457Professionalmedian $832 · 10th to 90th $617 to $1,738
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 $616.60 Median $1,584.89 Typical High $10,964.78 | Facility | None | $616.60 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,023.29 | Professional | None | $616.60 | $616.60 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,162.28 | Facility | None | $1,584.89 | $2,344.23 | $3,162.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,778.28 | Professional | None | $794.33 | $954.99 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,445.44 Typical High $2,570.40 | Facility | None | $794.33 | $1,445.44 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $1,412.54 | Professional | None | $602.56 | $645.65 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,445.44 | Professional | None | $933.25 | $933.25 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $2,238.72 | Facility | None | $724.44 | $1,202.26 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,122.02 | Professional | None | $660.69 | $707.95 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,691.53 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,691.53 | $12,022.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,513.56 | Professional | None | $524.81 | $676.08 | $1,513.56 |
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 $302.00 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $489.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $3,388.44 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $3,388.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,122.02 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,122.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,071.52 Typical High $2,238.72 | Professional | 50 · Both sides | $1,000.00 | $1,071.52 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $354.81 Typical High $741.31 | Professional | 51 · Multiple procedures | $331.13 | $354.81 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $144.54 Typical High $302.00 | Professional | 80 · Assistant surgeon | $131.83 | $144.54 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $100.00 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $93.33 | $100.00 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $100.00 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $100.00 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $100.00 Typical High $208.93 | Professional | AS · PA/NP assist | $93.33 | $100.00 | $208.93 |
Where North Carolina sits
The same service costs 7.2 times more in Alaska than in Utah. 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
$871
AK $2,570UT $355
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.