How much rates vary
Facilitymedian $589 · 10th to 90th $120 to $2,399Professionalmedian $1,072 · 10th to 90th $813 to $2,399
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 $954.99 Median $1,288.25 Typical High $8,317.64 | Facility | None | $954.99 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | None | $954.99 | $954.99 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $257.04 Median $380.19 Typical High $512.86 | Facility | None | $257.04 | $380.19 | $512.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $3,090.30 | Professional | None | $812.83 | $1,071.52 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $2,511.89 | Facility | None | $645.65 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,862.09 | Professional | None | $758.58 | $912.01 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $794.33 Typical High $2,630.27 | Facility | None | $275.42 | $794.33 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,202.26 | Professional | None | $912.01 | $1,122.02 | $1,202.26 |
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 $794.33 Median $977.24 Typical High $1,995.26 | Professional | None | $794.33 | $977.24 | $1,995.26 |
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 $467.74 Median $467.74 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $851.14 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $380.19 Median $1,071.52 Typical High $3,890.45 | Facility | 50 · Both sides | $380.19 | $1,071.52 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $128.82 Median $363.08 Typical High $1,318.26 | Facility | 51 · Multiple procedures | $128.82 | $363.08 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $562.34 Typical High $724.44 | Professional | 51 · Multiple procedures | $457.09 | $562.34 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $288.40 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $154.88 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $128.82 | $154.88 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $154.88 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $154.88 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $204.17 |
Where North Carolina sits
The same service costs 7.2 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· 34th of 51
$1,072
AK $3,890UT $537
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.