How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,023 to $9,120Professionalmedian $1,660 · 10th to 90th $1,148 to $3,311
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 $1,148.15 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,148.15 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,148.15 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,344.23 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,148.15 | $2,187.76 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,513.56 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,265.80 | Facility | None | $831.76 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,479.11 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,513.56 | $2,818.38 |
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 $575.44 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $891.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $3,019.95 Typical High $8,709.64 | Facility | 50 · Both sides | $1,258.93 | $3,019.95 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,187.76 Typical High $4,897.79 | Professional | 50 · Both sides | $1,995.26 | $2,187.76 | $4,897.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $741.31 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $660.69 | $741.31 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $295.12 Typical High $645.65 | Professional | 80 · Assistant surgeon | $263.03 | $295.12 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $204.17 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $186.21 | $204.17 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $204.17 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $204.17 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $204.17 Typical High $457.09 | Professional | AS · PA/NP assist | $186.21 | $204.17 | $457.09 |
Where North Carolina sits
The same service costs 6.8 times more in Alaska than in Texas. 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· 20th of 51
$1,820
AK $4,677TX $692
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.