How much rates vary
Facilitymedian $81 · 10th to 90th $50 to $851Professionalmedian $123 · 10th to 90th $83 to $224
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 $64.57 Median $89.13 Typical High $7,413.10 | Facility | None | $64.57 | $89.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $104.71 | Professional | None | $64.57 | $87.10 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
BCBS North Carolina Setting Facility Modifier None Typical Low $38.02 Median $56.23 Typical High $75.86 | Facility | None | $38.02 | $56.23 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $239.88 | Professional | None | $100.00 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $151.36 | Facility | None | $50.12 | $79.43 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $208.93 | Professional | None | $83.18 | $97.72 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | None | $134.90 | $134.90 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $109.65 | Facility | None | $47.86 | $69.18 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $144.54 | Professional | None | $97.72 | $109.65 | $144.54 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $190.55 | Professional | None | $63.10 | $95.50 | $190.55 |
10 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 54 · Surgery only Typical Low $48.98 Median $64.57 Typical High $67.61 | Professional | 54 · Surgery only | $48.98 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $45.71 Median $60.26 Typical High $63.10 | Professional | 78 · Unplanned return to OR | $45.71 | $60.26 | $63.10 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $67.61 Median $104.71 Typical High $165.96 | Facility | 50 · Both sides | $67.61 | $104.71 | $165.96 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $22.39 Median $34.67 Typical High $54.95 | Facility | 51 · Multiple procedures | $22.39 | $34.67 | $54.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $162.18 Typical High $323.59 | Professional | 50 · Both sides | $158.49 | $162.18 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $54.95 Typical High $109.65 | Professional | 51 · Multiple procedures | $53.70 | $54.95 | $109.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $21.88 Typical High $43.65 | Professional | 80 · Assistant surgeon | $21.38 | $21.88 | $43.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.79 Median $15.14 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $14.79 | $15.14 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.79 Median $15.14 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $14.79 | $15.14 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $15.14 Typical High $30.20 | Professional | AS · PA/NP assist | $14.79 | $15.14 | $30.20 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 12th of 51
$120
AK $269FL $69.18
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.