How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,000 to $11,220Professionalmedian $1,585 · 10th to 90th $912 to $3,020
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 $1,000.00 Median $1,000.00 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,000.00 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $8,511.38 | Facility | None | $4,168.69 | $6,165.95 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,995.26 Typical High $3,090.30 | Professional | None | $912.01 | $1,995.26 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $7,585.78 | Facility | None | $602.56 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,479.11 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,023.29 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,445.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,584.89 | $2,691.53 |
12 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 $501.19 Median $501.19 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,187.76 Typical High $4,365.16 | Professional | 50 · Both sides | $1,621.81 | $2,187.76 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $741.31 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $537.03 | $741.31 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $295.12 Typical High $575.44 | Professional | 80 · Assistant surgeon | $213.80 | $295.12 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $204.17 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $151.36 | $204.17 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $204.17 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $204.17 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $204.17 Typical High $407.38 | Professional | AS · PA/NP assist | $151.36 | $204.17 | $407.38 |
Where North Carolina sits
The same service costs 5.1 times more in Wisconsin 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· 20th of 51
$1,862
WI $4,677TX $912
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.