How much rates vary
Facilitymedian $162 · 10th to 90th $89 to $933Professionalmedian $148 · 10th to 90th $112 to $355
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 $112.20 Median $141.25 Typical High $7,413.10 | Facility | None | $112.20 | $141.25 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $239.88 | Professional | None | $112.20 | $141.25 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $125.89 Typical High $251.19 | Professional | None | $63.10 | $125.89 | $251.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $89.13 Median $138.04 Typical High $389.05 | Facility | None | $89.13 | $138.04 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $371.54 | Professional | None | $120.23 | $154.88 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $151.36 Typical High $234.42 | Facility | None | $56.23 | $151.36 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $257.04 | Professional | None | $93.33 | $123.03 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $263.03 | Facility | None | $112.20 | $169.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $213.80 | Professional | None | $134.90 | $173.78 | $213.80 |
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 $109.65 Median $141.25 Typical High $275.42 | Professional | None | $109.65 | $141.25 | $275.42 |
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 $56.23 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $85.11 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $100.00 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $79.43 | $100.00 | $112.20 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $162.18 Median $257.04 Typical High $389.05 | Facility | 50 · Both sides | $162.18 | $257.04 | $389.05 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $54.95 Median $85.11 Typical High $131.83 | Facility | 51 · Multiple procedures | $54.95 | $85.11 | $131.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $295.12 Typical High $407.38 | Professional | 50 · Both sides | $199.53 | $295.12 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $97.72 Typical High $134.90 | Professional | 51 · Multiple procedures | $67.61 | $97.72 | $134.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $39.81 Typical High $54.95 | Professional | 80 · Assistant surgeon | $26.92 | $39.81 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $27.54 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $18.62 | $27.54 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $27.54 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $27.54 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $27.54 Typical High $38.02 | Professional | AS · PA/NP assist | $18.62 | $27.54 | $38.02 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 36th of 51
$148
AK $468FL $115
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.