How much rates vary
Facilitymedian $2,089 · 10th to 90th $617 to $6,761Professionalmedian $1,413 · 10th to 90th $437 to $3,090
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 $371.54 Median $1,258.93 Typical High $7,943.28 | Facility | None | $371.54 | $1,258.93 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,202.26 Typical High $1,698.24 | Professional | None | $371.54 | $1,202.26 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $6,606.93 | Facility | None | $1,659.59 | $2,570.40 | $6,606.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $3,467.37 | Professional | None | $616.60 | $1,412.54 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $3,235.94 | Facility | None | $645.65 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,511.89 | Professional | None | $426.58 | $1,148.15 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,380.38 Typical High $2,454.71 | Facility | None | $575.44 | $1,380.38 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,949.84 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $2,818.38 | Professional | None | $398.11 | $1,230.27 | $2,818.38 |
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 $186.21 Median $275.42 Typical High $645.65 | Professional | 52 · Reduced service | $186.21 | $275.42 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $109.65 Typical High $257.04 | Professional | 53 · Discontinued | $75.86 | $109.65 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $416.87 Typical High $954.99 | Professional | 54 · Surgery only | $281.84 | $416.87 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $83.18 Typical High $194.98 | Professional | 55 · Aftercare only | $56.23 | $83.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $54.95 Typical High $128.82 | Professional | 56 · Pre-op care only | $37.15 | $54.95 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $389.05 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $263.03 | $389.05 | $891.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,041.74 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $2,041.74 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $691.83 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $691.83 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $3,311.31 Typical High $5,248.07 | Professional | 50 · Both sides | $1,737.80 | $3,311.31 | $5,248.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $1,096.48 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $575.44 | $1,096.48 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $436.52 Typical High $707.95 | Professional | 80 · Assistant surgeon | $229.09 | $436.52 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $309.03 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $162.18 | $309.03 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $309.03 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $309.03 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $309.03 Typical High $489.78 | Professional | AS · PA/NP assist | $162.18 | $309.03 | $489.78 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 22nd of 51
$1,413
AK $3,020NE $692
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.