How much rates vary
Facilitymedian $2,455 · 10th to 90th $741 to $6,026Professionalmedian $661 · 10th to 90th $417 to $1,175
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 $398.11 Median $602.56 Typical High $10,471.29 | Facility | None | $398.11 | $602.56 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,548.13 | Facility | None | $1,737.80 | $2,570.40 | $3,548.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Professional | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,467.37 | Facility | None | $794.33 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | None | $416.87 | $416.87 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,479.11 Typical High $2,754.23 | Facility | None | $676.08 | $1,479.11 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $660.69 | Professional | None | $380.19 | $524.81 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $478.63 | Professional | None | $457.09 | $457.09 | $478.63 |
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 $407.38 Typical High $758.58 | Professional | None | $346.74 | $407.38 | $758.58 |
15 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 $199.53 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $323.59 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 50 · Both sides | $426.58 | $426.58 | $426.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,238.72 Typical High $5,370.32 | Facility | 50 · Both sides | $1,096.48 | $2,238.72 | $5,370.32 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $741.31 Typical High $1,778.28 | Facility | 51 · Multiple procedures | $363.08 | $741.31 | $1,778.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $575.44 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | 51 · Multiple procedures | $190.55 | $275.42 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $109.65 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $109.65 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $53.70 | $75.86 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $75.86 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $75.86 Typical High $93.33 | Professional | AS · PA/NP assist | $53.70 | $75.86 | $93.33 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 13th of 51
$676
AK $1,660UT $295
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.