How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $11,220Professionalmedian $617 · 10th to 90th $447 to $1,259
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 $416.87 Median $1,584.89 Typical High $11,481.54 | Facility | None | $416.87 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | None | $416.87 | $416.87 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,630.27 Median $4,073.80 Typical High $10,471.29 | Facility | None | $2,630.27 | $4,073.80 | $10,471.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,258.93 | Professional | None | $562.34 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,011.87 Typical High $6,025.60 | Facility | None | $1,698.24 | $5,011.87 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,122.02 | Professional | None | $457.09 | $562.34 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,445.44 | $2,137.96 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $758.58 | Professional | None | $478.63 | $575.44 | $758.58 |
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 $389.05 Median $512.86 Typical High $1,047.13 | Professional | None | $389.05 | $512.86 | $1,047.13 |
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 $208.93 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $354.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,715.35 Typical High $8,511.38 | Facility | 50 · Both sides | $2,344.23 | $3,715.35 | $8,511.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,230.27 Typical High $2,818.38 | Facility | 51 · Multiple procedures | $776.25 | $1,230.27 | $2,818.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,819.70 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $288.40 Typical High $616.60 | Professional | 51 · Multiple procedures | $234.42 | $288.40 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $114.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $95.50 | $114.82 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $79.43 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $66.07 | $79.43 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $79.43 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $79.43 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $79.43 Typical High $169.82 | Professional | AS · PA/NP assist | $66.07 | $79.43 | $169.82 |
Where North Carolina sits
The same service costs 9.5 times more in Oklahoma 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· 20th of 51
$724
OK $3,236UT $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.