How much rates vary
Facilitymedian $5,248 · 10th to 90th $871 to $9,772Professionalmedian $513 · 10th to 90th $355 to $776
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 $562.34 Median $1,000.00 Typical High $7,943.28 | Facility | None | $562.34 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $9,332.54 | Facility | None | $4,786.30 | $7,079.46 | $9,332.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $724.44 | Professional | None | $363.08 | $489.78 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $8,912.51 | Facility | None | $489.78 | $1,698.24 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,412.54 | Professional | None | $588.84 | $616.60 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $5,370.32 Typical High $5,370.32 | Facility | None | $562.34 | $5,370.32 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $851.14 | Professional | None | $436.52 | $676.08 | $851.14 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,951.21 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,951.21 | $12,302.69 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $645.65 | Professional | None | $251.19 | $371.54 | $645.65 |
11 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 $281.84 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $67.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,023.29 Typical High $2,041.74 | Professional | 50 · Both sides | $660.69 | $1,023.29 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $346.74 Typical High $676.08 | Professional | 51 · Multiple procedures | $218.78 | $346.74 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $138.04 Typical High $269.15 | Professional | 80 · Assistant surgeon | $87.10 | $138.04 | $269.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $95.50 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $61.66 | $95.50 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $95.50 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $95.50 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $95.50 Typical High $190.55 | Professional | AS · PA/NP assist | $61.66 | $95.50 | $190.55 |
Where North Carolina sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 39th of 51
$525
AK $2,344HI $224
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.