How much rates vary
Facilitymedian $3,162 · 10th to 90th $977 to $11,749Professionalmedian $1,820 · 10th to 90th $1,122 to $3,236
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 $1,258.93 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,258.93 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $8,128.31 | Facility | None | $2,041.74 | $3,235.94 | $8,128.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,122.02 | $2,630.27 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $4,786.30 | Facility | None | $831.76 | $1,819.70 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,801.89 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,380.38 | $2,754.23 |
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 $630.96 Median $630.96 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,148.15 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,754.23 Typical High $7,079.46 | Facility | 50 · Both sides | $1,258.93 | $2,754.23 | $7,079.46 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $912.01 Typical High $2,344.23 | Facility | 51 · Multiple procedures | $416.87 | $912.01 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,454.71 Typical High $2,511.89 | Professional | 50 · Both sides | $1,862.09 | $2,454.71 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $812.83 Typical High $851.14 | Professional | 51 · Multiple procedures | $616.60 | $812.83 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $323.59 Typical High $338.84 | Professional | 80 · Assistant surgeon | $245.47 | $323.59 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $229.09 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $173.78 | $229.09 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $229.09 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $229.09 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $229.09 Typical High $234.42 | Professional | AS · PA/NP assist | $173.78 | $229.09 | $234.42 |
Where North Carolina sits
The same service costs 8.3 times more in Wyoming 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· 19th of 51
$2,089
WY $5,623UT $676
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.