How much rates vary
Facilitymedian $5,129 · 10th to 90th $955 to $11,220Professionalmedian $1,820 · 10th to 90th $1,096 to $2,884
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 $954.99 Median $954.99 Typical High $7,943.28 | Facility | None | $954.99 | $954.99 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $8,709.64 | Facility | None | $4,168.69 | $6,165.95 | $8,709.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,862.09 | $3,019.95 |
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 $1,230.27 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,445.44 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,000.00 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,348.96 | $1,621.81 |
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 $977.24 Median $1,513.56 Typical High $2,630.27 | Professional | None | $977.24 | $1,513.56 | $2,630.27 |
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 $478.63 Median $478.63 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,089.30 Typical High $4,265.80 | Professional | 50 · Both sides | $1,513.56 | $2,089.30 | $4,265.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $691.83 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $501.19 | $691.83 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $275.42 Typical High $562.34 | Professional | 80 · Assistant surgeon | $204.17 | $275.42 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $141.25 | $194.98 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $194.98 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | AS · PA/NP assist | $141.25 | $194.98 | $398.11 |
Where North Carolina sits
The same service costs 5.0 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· 18th of 51
$1,862
WI $4,365TX $871
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.