How much rates vary
Facilitymedian $1,445 · 10th to 90th $562 to $5,248Professionalmedian $661 · 10th to 90th $457 to $1,349
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 $446.68 Median $1,000.00 Typical High $7,943.28 | Facility | None | $446.68 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,380.38 | Professional | None | $575.44 | $776.25 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $1,905.46 | Facility | None | $602.56 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,148.15 | Professional | None | $489.78 | $512.86 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,071.52 | Professional | None | $707.95 | $707.95 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $1,513.56 | Facility | None | $524.81 | $831.76 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $741.31 | Professional | None | $457.09 | $562.34 | $741.31 |
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 $398.11 Median $537.03 Typical High $1,122.02 | Professional | None | $398.11 | $537.03 | $1,122.02 |
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 $223.87 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $380.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,412.54 Typical High $3,162.28 | Facility | 50 · Both sides | $776.25 | $1,412.54 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $467.74 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $263.03 | $467.74 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $851.14 Typical High $1,659.59 | Professional | 50 · Both sides | $691.83 | $851.14 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $281.84 Typical High $549.54 | Professional | 51 · Multiple procedures | $229.09 | $281.84 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $218.78 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $79.43 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $64.57 | $79.43 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $79.43 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $79.43 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $79.43 Typical High $154.88 | Professional | AS · PA/NP assist | $64.57 | $79.43 | $154.88 |
Where North Carolina sits
The same service costs 5.8 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· 23rd of 51
$676
AK $1,862UT $324
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.