How much rates vary
Facilitymedian $407 · 10th to 90th $148 to $2,951Professionalmedian $417 · 10th to 90th $166 to $1,349
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 $120.23 Median $223.87 Typical High $10,000.00 | Facility | None | $120.23 | $223.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $346.74 | Professional | None | $120.23 | $223.87 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | None | $194.98 | $194.98 | $331.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $123.03 Median $177.83 Typical High $239.88 | Facility | None | $123.03 | $177.83 | $239.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $251.19 Median $691.83 Typical High $1,548.82 | Professional | None | $251.19 | $691.83 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $2,818.38 | Facility | None | $173.78 | $281.84 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $812.83 | Professional | None | $177.83 | $407.38 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $331.13 Typical High $1,148.15 | Facility | None | $138.04 | $331.13 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $933.25 Typical High $933.25 | Professional | None | $229.09 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $831.76 | Professional | None | $123.03 | $257.04 | $831.76 |
13 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 $60.26 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $60.26 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $23.99 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $138.04 Typical High $165.96 | Professional | 54 · Surgery only | $91.20 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $18.20 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.02 | $18.20 | $22.39 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $204.17 Median $501.19 Typical High $1,737.80 | Facility | 50 · Both sides | $204.17 | $501.19 | $1,737.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $67.61 Median $165.96 Typical High $575.44 | Facility | 51 · Multiple procedures | $67.61 | $165.96 | $575.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $1,380.38 Typical High $1,412.54 | Professional | 50 · Both sides | $457.09 | $1,380.38 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $467.74 Typical High $467.74 | Professional | 51 · Multiple procedures | $151.36 | $467.74 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $186.21 Typical High $186.21 | Professional | 80 · Assistant surgeon | $60.26 | $186.21 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $128.82 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $42.66 | $128.82 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $128.82 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $128.82 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $128.82 Typical High $131.83 | Professional | AS · PA/NP assist | $42.66 | $128.82 | $131.83 |
Where North Carolina sits
The same service costs 3.2 times more in Oklahoma 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· 5th of 51
$417
OK $692TX $214
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.