How much rates vary
Facilitymedian $2,042 · 10th to 90th $646 to $5,754Professionalmedian $1,349 · 10th to 90th $389 to $3,236
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 $323.59 Median $1,479.11 Typical High $7,943.28 | Facility | None | $323.59 | $1,479.11 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,479.11 Typical High $1,819.70 | Professional | None | $323.59 | $1,479.11 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,348.96 | $1,995.26 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $524.81 Median $1,148.15 Typical High $3,388.44 | Professional | None | $524.81 | $1,148.15 | $3,388.44 |
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 $371.54 Median $1,071.52 Typical High $2,951.21 | Professional | None | $371.54 | $1,071.52 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $3,162.28 | Facility | None | $575.44 | $1,071.52 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,737.80 | $2,344.23 |
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 $346.74 Median $1,230.27 Typical High $3,162.28 | Professional | None | $346.74 | $1,230.27 | $3,162.28 |
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 $162.18 Median $257.04 Typical High $758.58 | Professional | 52 · Reduced service | $162.18 | $257.04 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $104.71 Typical High $302.00 | Professional | 53 · Discontinued | $64.57 | $104.71 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $1,122.02 | Professional | 54 · Surgery only | $245.47 | $389.05 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $77.62 Typical High $223.87 | Professional | 55 · Aftercare only | $48.98 | $77.62 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $151.36 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $363.08 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $229.09 | $363.08 | $1,047.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,621.81 Typical High $5,248.07 | Facility | 50 · Both sides | $891.25 | $1,621.81 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $537.03 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $295.12 | $537.03 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $3,467.37 Typical High $6,165.95 | Professional | 50 · Both sides | $2,041.74 | $3,467.37 | $6,165.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $1,174.90 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $676.08 | $1,174.90 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $467.74 Typical High $812.83 | Professional | 80 · Assistant surgeon | $269.15 | $467.74 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $323.59 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $190.55 | $323.59 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $323.59 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $323.59 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $323.59 Typical High $575.44 | Professional | AS · PA/NP assist | $190.55 | $323.59 | $575.44 |
Where North Carolina sits
The same service costs 5.8 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· 27th of 51
$1,479
AK $3,548NE $617
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.