How much rates vary
Facilitymedian $3,388 · 10th to 90th $813 to $10,000Professionalmedian $1,479 · 10th to 90th $813 to $1,995
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 $812.83 Median $1,288.25 Typical High $10,471.29 | Facility | None | $812.83 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,659.59 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $2,041.74 | Professional | None | $831.76 | $1,023.29 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $4,265.80 | Facility | None | $741.31 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,348.96 | Professional | None | $831.76 | $954.99 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $2,041.74 | Professional | None | $758.58 | $954.99 | $2,041.74 |
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 $407.38 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $707.95 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $3,019.95 Typical High $8,709.64 | Facility | 50 · Both sides | $1,096.48 | $3,019.95 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,445.44 Typical High $3,388.44 | Professional | 50 · Both sides | $1,258.93 | $1,445.44 | $3,388.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $478.63 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $416.87 | $478.63 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $190.55 Typical High $446.68 | Professional | 80 · Assistant surgeon | $165.96 | $190.55 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $134.90 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $117.49 | $134.90 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $134.90 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $134.90 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $134.90 Typical High $316.23 | Professional | AS · PA/NP assist | $117.49 | $134.90 | $316.23 |
Where North Carolina sits
The same service costs 7.4 times more in Oklahoma 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· 16th of 51
$1,549
OK $3,890TX $525
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.