How much rates vary
Facilitymedian $339 · 10th to 90th $107 to $1,230Professionalmedian $331 · 10th to 90th $158 to $676
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 $131.83 Median $269.15 Typical High $7,585.78 | Facility | None | $131.83 | $269.15 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $302.00 | Professional | None | $131.83 | $251.19 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $407.38 | Facility | None | $102.33 | $158.49 | $407.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $758.58 | Professional | None | $213.80 | $389.05 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $407.38 Typical High $1,737.80 | Facility | None | $257.04 | $407.38 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $524.81 | Professional | None | $165.96 | $288.40 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $131.83 Median $426.58 Typical High $741.31 | Facility | None | $131.83 | $426.58 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $446.68 | Professional | None | $257.04 | $316.23 | $446.68 |
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 $131.83 Median $251.19 Typical High $524.81 | Professional | None | $131.83 | $251.19 | $524.81 |
13 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 $66.07 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $66.07 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $26.30 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $97.72 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $19.50 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $28.84 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $131.83 Median $776.25 Typical High $1,412.54 | Facility | 50 · Both sides | $131.83 | $776.25 | $1,412.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $43.65 Median $257.04 Typical High $467.74 | Facility | 51 · Multiple procedures | $43.65 | $257.04 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $478.63 Typical High $1,096.48 | Professional | 50 · Both sides | $389.05 | $478.63 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $158.49 Typical High $363.08 | Professional | 51 · Multiple procedures | $128.82 | $158.49 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $64.57 Typical High $144.54 | Professional | 80 · Assistant surgeon | $51.29 | $64.57 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $44.67 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $36.31 | $44.67 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $44.67 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $44.67 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $44.67 Typical High $102.33 | Professional | AS · PA/NP assist | $36.31 | $44.67 | $102.33 |
Where North Carolina sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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
$331
WI $646KY $204
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.