How much rates vary
Facilitymedian $1,862 · 10th to 90th $417 to $5,623Professionalmedian $501 · 10th to 90th $251 to $1,023
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 $338.84 Median $1,000.00 Typical High $7,943.28 | Facility | None | $338.84 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | None | $338.84 | $338.84 | $446.68 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $5,128.61 | Facility | None | $1,288.25 | $1,949.84 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $251.19 Median $676.08 Typical High $1,023.29 | Professional | None | $251.19 | $676.08 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $3,388.44 | Facility | None | $457.09 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $912.01 | Professional | None | $371.54 | $478.63 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,511.89 | Facility | None | $371.54 | $776.25 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $616.60 | Professional | None | $407.38 | $457.09 | $616.60 |
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 $323.59 Median $416.87 Typical High $851.14 | Professional | None | $323.59 | $416.87 | $851.14 |
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 $169.82 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $295.12 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,548.82 Typical High $5,495.41 | Facility | 50 · Both sides | $562.34 | $1,548.82 | $5,495.41 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $524.81 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $186.21 | $524.81 | $1,819.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $691.83 Typical High $1,479.11 | Professional | 50 · Both sides | $602.56 | $691.83 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $229.09 Typical High $489.78 | Professional | 51 · Multiple procedures | $204.17 | $229.09 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $91.20 Typical High $199.53 | Professional | 80 · Assistant surgeon | $81.28 | $91.20 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $56.23 Median $64.57 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $56.23 | $64.57 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $64.57 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $64.57 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $64.57 Typical High $138.04 | Professional | AS · PA/NP assist | $56.23 | $64.57 | $138.04 |
Where North Carolina sits
The same service costs 6.9 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· 20th of 51
$575
AK $1,905UT $275
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.