How much rates vary
Facilitymedian $1,259 · 10th to 90th $355 to $2,951Professionalmedian $741 · 10th to 90th $525 to $1,514
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 $602.56 Median $1,000.00 Typical High $10,471.29 | Facility | None | $602.56 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $870.96 | Professional | None | $602.56 | $602.56 | $870.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $5,888.44 | Facility | None | $1,380.38 | $2,290.87 | $5,888.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,737.80 | Professional | None | $537.03 | $741.31 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $2,570.40 | Facility | None | $794.33 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $1,174.90 | Professional | None | $416.87 | $467.74 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,137.96 | Facility | None | $724.44 | $1,174.90 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,096.48 | Professional | None | $588.84 | $758.58 | $1,096.48 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,288.25 | Professional | None | $501.19 | $602.56 | $1,288.25 |
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 $302.00 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $302.00 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $549.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $1,819.70 Typical High $3,235.94 | Facility | 50 · Both sides | $1,096.48 | $1,819.70 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $870.96 | $1,258.93 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $416.87 Typical High $549.54 | Professional | 51 · Multiple procedures | $295.12 | $416.87 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $117.49 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $117.49 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $81.28 | $117.49 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $117.49 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $117.49 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $81.28 | $117.49 | $154.88 |
Where North Carolina sits
The same service costs 7.6 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· 32nd of 51
$741
AK $2,512UT $331
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.