How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $6,918Professionalmedian $1,585 · 10th to 90th $1,023 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 $1,318.26 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,318.26 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
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 $1,023.29 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,023.29 | $2,290.87 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $4,365.16 | Facility | None | $912.01 | $3,090.30 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,230.27 | $2,511.89 |
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 $1,258.93 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,412.54 | $1,737.80 |
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 $1,023.29 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,258.93 | $2,570.40 |
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 $660.69 Median $660.69 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,148.15 |
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 $1,905.46 Median $2,137.96 Typical High $2,630.27 | Professional | 50 · Both sides | $1,905.46 | $2,137.96 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $707.95 Typical High $870.96 | Professional | 51 · Multiple procedures | $630.96 | $707.95 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | 80 · Assistant surgeon | $251.19 | $281.84 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $177.83 | $199.53 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $199.53 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | AS · PA/NP assist | $177.83 | $199.53 | $245.47 |
Where North Carolina sits
The same service costs 7.1 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· 21st of 51
$1,820
AK $5,370UT $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.