How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,000 to $14,791Professionalmedian $2,399 · 10th to 90th $1,259 to $4,169
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 $1,258.93 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,258.93 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,258.93 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,890.45 Median $6,025.60 Typical High $15,488.17 | Facility | None | $3,890.45 | $6,025.60 | $15,488.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $4,168.69 | Professional | None | $1,258.93 | $3,090.30 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,760.83 Typical High $11,220.18 | Facility | None | $602.56 | $6,760.83 | $11,220.18 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,258.93 | $5,248.07 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,570.40 | Professional | None | $933.25 | $1,479.11 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,288.25 | $2,041.74 | $5,495.41 |
9 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 $630.96 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $741.31 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $467.74 | $741.31 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $295.12 Typical High $741.31 | Professional | 80 · Assistant surgeon | $186.21 | $295.12 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $208.93 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $131.83 | $208.93 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $208.93 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $208.93 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $208.93 Typical High $512.86 | Professional | AS · PA/NP assist | $131.83 | $208.93 | $512.86 |
Where North Carolina sits
The same service costs 9.1 times more in Oklahoma 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· 19th of 51
$2,818
OK $10,233NY $1,122
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.