How much rates vary
Facilitymedian $1,950 · 10th to 90th $417 to $7,079Professionalmedian $525 · 10th to 90th $389 to $1,047
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 $346.74 Median $1,000.00 Typical High $7,943.28 | Facility | None | $346.74 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | None | $346.74 | $346.74 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,754.40 | Facility | None | $1,445.44 | $2,238.72 | $5,754.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,047.13 | Professional | None | $446.68 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $3,630.78 Typical High $5,370.32 | Facility | None | $457.09 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $933.25 | Professional | None | $416.87 | $501.19 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $3,801.89 | Facility | None | $371.54 | $776.25 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $602.56 | Professional | None | $416.87 | $489.78 | $602.56 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $851.14 | Professional | None | $354.81 | $457.09 | $851.14 |
13 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 $173.78 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $42.66 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,778.28 Typical High $7,762.47 | Facility | 50 · Both sides | $562.34 | $1,778.28 | $7,762.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $588.84 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $186.21 | $588.84 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $741.31 Typical High $1,548.82 | Professional | 50 · Both sides | $676.08 | $741.31 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $245.47 Typical High $512.86 | Professional | 51 · Multiple procedures | $223.87 | $245.47 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $97.72 Typical High $204.17 | Professional | 80 · Assistant surgeon | $89.13 | $97.72 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $69.18 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $63.10 | $69.18 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $69.18 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $69.18 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $69.18 Typical High $144.54 | Professional | AS · PA/NP assist | $63.10 | $69.18 | $144.54 |
Where North Carolina sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 23rd of 51
$589
OK $2,630NY $339
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.