How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $5,248Professionalmedian $457 · 10th to 90th $117 to $832
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 $1,288.25 Typical High $8,317.64 | Facility | None | $338.84 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,801.89 | Facility | None | $1,905.46 | $2,818.38 | $3,801.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $117.49 Median $588.84 Typical High $831.76 | Professional | None | $117.49 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $3,467.37 | Facility | None | $645.65 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $812.83 | Professional | None | $346.74 | $436.52 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $977.24 Typical High $2,398.83 | Facility | None | $549.54 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $549.54 | Professional | None | $363.08 | $398.11 | $549.54 |
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 $302.00 Median $426.58 Typical High $831.76 | Professional | None | $302.00 | $426.58 | $831.76 |
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 $165.96 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $263.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,454.71 Typical High $4,677.35 | Facility | 50 · Both sides | $891.25 | $2,454.71 | $4,677.35 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $812.83 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $295.12 | $812.83 | $1,548.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $588.84 Typical High $1,380.38 | Professional | 50 · Both sides | $549.54 | $588.84 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $199.53 Typical High $467.74 | Professional | 51 · Multiple procedures | $181.97 | $199.53 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $79.43 Typical High $186.21 | Professional | 80 · Assistant surgeon | $74.13 | $79.43 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $54.95 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $51.29 | $54.95 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $54.95 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $54.95 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $54.95 Typical High $128.82 | Professional | AS · PA/NP assist | $51.29 | $54.95 | $128.82 |
Where North Carolina sits
The same service costs 11.7 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
$550
OK $2,754UT $234
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.