How much rates vary
Facilitymedian $27,542 · 10th to 90th $871 to $50,119Professionalmedian $562 · 10th to 90th $76 to $1,023
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 $389.05 Median $1,584.89 Typical High $11,481.54 | Facility | None | $389.05 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $1,584.89 | Professional | None | $371.54 | $389.05 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19,498.45 Median $32,359.37 Typical High $50,118.72 | Facility | None | $19,498.45 | $32,359.37 | $50,118.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $630.96 Typical High $1,023.29 | Professional | None | $75.86 | $630.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $27,542.29 Typical High $38,018.94 | Facility | None | $602.56 | $27,542.29 | $38,018.94 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $25,118.86 Typical High $56,234.13 | Facility | None | $407.38 | $25,118.86 | $56,234.13 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $630.96 | Professional | None | $263.03 | $371.54 | $630.96 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $28,183.83 Typical High $74,131.02 | Facility | None | $2,344.23 | $28,183.83 | $74,131.02 |
United Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $1,047.13 | Professional | None | $398.11 | $630.96 | $1,047.13 |
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 $181.97 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $275.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $38.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $186.21 Typical High $524.81 | Professional | 51 · Multiple procedures | $131.83 | $186.21 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $74.13 Typical High $208.93 | Professional | 80 · Assistant surgeon | $52.48 | $74.13 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $52.48 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $36.31 | $52.48 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $52.48 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $52.48 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $52.48 Typical High $147.91 | Professional | AS · PA/NP assist | $36.31 | $52.48 | $147.91 |
Where North Carolina sits
The same service costs 57.5 times more in Arkansas 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· 41st of 51
$692
AR $17,783NY $309
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.