How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $4,898Professionalmedian $851 · 10th to 90th $447 to $1,549
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 $457.09 Median $630.96 Typical High $7,943.28 | Facility | None | $457.09 | $630.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $707.95 | Professional | None | $457.09 | $602.56 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $302.00 Median $1,000.00 Typical High $1,659.59 | Professional | None | $302.00 | $1,000.00 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,951.21 | Facility | None | $645.65 | $2,089.30 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,445.44 | Professional | None | $489.78 | $691.83 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $2,454.71 | Facility | None | $575.44 | $977.24 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,047.13 | Professional | None | $524.81 | $794.33 | $1,047.13 |
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 $446.68 Median $645.65 Typical High $1,513.56 | Professional | None | $446.68 | $645.65 | $1,513.56 |
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 $229.09 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $69.18 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $446.68 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,659.59 Typical High $3,890.45 | Facility | 50 · Both sides | $891.25 | $1,659.59 | $3,890.45 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $549.54 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $295.12 | $549.54 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,202.26 Typical High $2,570.40 | Professional | 50 · Both sides | $776.25 | $1,202.26 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $398.11 Typical High $870.96 | Professional | 51 · Multiple procedures | $263.03 | $398.11 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $158.49 Typical High $346.74 | Professional | 80 · Assistant surgeon | $104.71 | $158.49 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $112.20 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $72.44 | $112.20 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $112.20 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $112.20 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $112.20 Typical High $239.88 | Professional | AS · PA/NP assist | $72.44 | $112.20 | $239.88 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 17th of 51
$891
AK $2,291KY $562
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.