How much rates vary
Facilitymedian $117 · 10th to 90th $65 to $891Professionalmedian $158 · 10th to 90th $71 to $339
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 $53.70 Median $100.00 Typical High $5,248.07 | Facility | None | $53.70 | $100.00 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $147.91 | Professional | None | $53.70 | $100.00 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $120.23 | Professional | None | $60.26 | $77.62 | $120.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $346.74 | Facility | None | $87.10 | $138.04 | $346.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $380.19 | Professional | None | $97.72 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $104.71 Typical High $154.88 | Facility | None | $56.23 | $104.71 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $234.42 | Professional | None | $79.43 | $141.25 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $117.49 Typical High $154.88 | Facility | None | $75.86 | $117.49 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $208.93 | Professional | None | $107.15 | $162.18 | $208.93 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $213.80 | Professional | None | $57.54 | $109.65 | $213.80 |
11 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 $26.92 Median $42.66 Typical High $50.12 | Professional | 52 · Reduced service | $26.92 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $10.72 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $39.81 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.37 | $8.51 | $10.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $58.88 Typical High $77.62 | Facility | 51 · Multiple procedures | $40.74 | $58.88 | $77.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $85.11 Typical High $138.04 | Professional | 51 · Multiple procedures | $54.95 | $85.11 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $33.88 Typical High $54.95 | Professional | 80 · Assistant surgeon | $21.88 | $33.88 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.49 Median $23.99 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $15.49 | $23.99 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.49 Median $23.99 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $15.49 | $23.99 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.49 Median $23.99 Typical High $38.02 | Professional | AS · PA/NP assist | $15.49 | $23.99 | $38.02 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 7th of 51
$151
AK $257PA $93.33
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.