How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $5,248Professionalmedian $437 · 10th to 90th $288 to $813
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 $288.40 Median $870.96 Typical High $7,943.28 | Facility | None | $288.40 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,621.81 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $831.76 | Professional | None | $371.54 | $524.81 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $4,168.69 | Facility | None | $602.56 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $724.44 | Professional | None | $316.23 | $380.19 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $2,398.83 | Facility | None | $524.81 | $1,380.38 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $537.03 | Professional | None | $316.23 | $371.54 | $537.03 |
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 $269.15 Median $389.05 Typical High $707.95 | Professional | None | $269.15 | $389.05 | $707.95 |
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 $144.54 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 54 · Surgery only | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $223.87 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,348.96 Median $2,089.30 Typical High $4,677.35 | Facility | 50 · Both sides | $1,348.96 | $2,089.30 | $4,677.35 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $446.68 Median $691.83 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $446.68 | $691.83 | $1,548.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $562.34 Typical High $1,230.27 | Professional | 50 · Both sides | $537.03 | $562.34 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $186.21 Typical High $407.38 | Professional | 51 · Multiple procedures | $177.83 | $186.21 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $74.13 Typical High $162.18 | Professional | 80 · Assistant surgeon | $70.79 | $74.13 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $52.48 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $50.12 | $52.48 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $52.48 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $52.48 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $52.48 Typical High $114.82 | Professional | AS · PA/NP assist | $50.12 | $52.48 | $114.82 |
Where North Carolina sits
The same service costs 6.0 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
$490
OK $1,479UT $245
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.