How much rates vary
Facilitymedian $2,692 · 10th to 90th $871 to $7,413Professionalmedian $759 · 10th to 90th $76 to $1,318
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 $501.19 Median $1,288.25 Typical High $8,317.64 | Facility | None | $501.19 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | None | $501.19 | $501.19 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $3,715.35 | Facility | None | $1,862.09 | $2,754.23 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $851.14 Typical High $1,380.38 | Professional | None | $75.86 | $851.14 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $5,011.87 | Facility | None | $602.56 | $3,019.95 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $2,691.53 Typical High $6,456.54 | Facility | None | $537.03 | $2,691.53 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $812.83 | Professional | None | $338.84 | $489.78 | $812.83 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,412.54 | Professional | None | $524.81 | $812.83 | $1,412.54 |
10 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 $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $50.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $245.47 Typical High $691.83 | Professional | 51 · Multiple procedures | $169.82 | $245.47 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $97.72 Typical High $275.42 | Professional | 80 · Assistant surgeon | $67.61 | $97.72 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $67.61 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $47.86 | $67.61 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $67.61 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $67.61 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $67.61 Typical High $190.55 | Professional | AS · PA/NP assist | $47.86 | $67.61 | $190.55 |
Where North Carolina sits
The same service costs 10.2 times more in Texas than in New York. 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· 39th of 51
$912
TX $4,074NY $398
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.