How much rates vary
Facilitymedian $1,445 · 10th to 90th $209 to $4,898Professionalmedian $1,148 · 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 $1,445.44 Typical High $10,715.19 | Facility | None | $954.99 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,348.96 | Professional | None | $954.99 | $954.99 | $1,348.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $302.00 | Facility | None | $151.36 | $223.87 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $3,090.30 | Professional | None | $812.83 | $1,148.15 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,019.95 | Facility | None | $912.01 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,862.09 | Professional | None | $776.25 | $933.25 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $1,023.29 Typical High $2,630.27 | Facility | None | $95.50 | $1,023.29 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,148.15 | Professional | None | $933.25 | $1,122.02 | $1,148.15 |
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 $794.33 Median $1,000.00 Typical High $1,995.26 | Professional | None | $794.33 | $1,000.00 | $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 $478.63 Median $478.63 Typical High $616.60 | Professional | 52 · Reduced service | $478.63 | $478.63 | $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 $724.44 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $186.21 |
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 $676.08 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $870.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $134.90 Median $1,479.11 Typical High $3,890.45 | Facility | 50 · Both sides | $134.90 | $1,479.11 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $44.67 Median $489.78 Typical High $1,318.26 | Facility | 51 · Multiple procedures | $44.67 | $489.78 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $1,819.70 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $562.34 Typical High $602.56 | Professional | 51 · Multiple procedures | $467.74 | $562.34 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $245.47 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $128.82 | $154.88 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $154.88 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $169.82 |
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· 33rd of 51
$1,148
AK $3,981UT $550
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.