How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,000 to $6,310Professionalmedian $1,288 · 10th to 90th $575 to $3,388
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 $1,348.96 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,348.96 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,348.96 | $1,737.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,365.16 | Facility | None | $2,137.96 | $3,162.28 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $1,148.15 Typical High $3,981.07 | Professional | None | $575.44 | $1,148.15 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,467.37 | Facility | None | $912.01 | $2,818.38 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,258.93 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $3,467.37 | Facility | None | $831.76 | $1,737.80 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,479.11 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,318.26 | $2,630.27 |
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 $676.08 Median $676.08 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,174.90 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,630.27 Typical High $5,248.07 | Facility | 50 · Both sides | $1,258.93 | $2,630.27 | $5,248.07 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $870.96 Typical High $1,737.80 | Facility | 51 · Multiple procedures | $416.87 | $870.96 | $1,737.80 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,187.76 Typical High $2,398.83 | Professional | 50 · Both sides | $1,949.84 | $2,187.76 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $741.31 Typical High $794.33 | Professional | 51 · Multiple procedures | $645.65 | $741.31 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 80 · Assistant surgeon | $257.04 | $295.12 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $181.97 | $204.17 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $204.17 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | AS · PA/NP assist | $181.97 | $204.17 | $223.87 |
Where North Carolina sits
The same service costs 7.4 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· 42nd of 51
$1,349
AK $5,623UT $759
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.