How much rates vary
Facilitymedian $479 · 10th to 90th $132 to $1,862Professionalmedian $646 · 10th to 90th $138 to $1,585
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 $131.83 Median $645.65 Typical High $5,248.07 | Facility | None | $131.83 | $645.65 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $616.60 Typical High $1,047.13 | Professional | None | $131.83 | $616.60 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $213.80 | Professional | None | $97.72 | $173.78 | $213.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $234.42 | Facility | None | $117.49 | $173.78 | $234.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $891.25 Typical High $1,778.28 | Professional | None | $177.83 | $891.25 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $933.25 | Facility | None | $371.54 | $630.96 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $512.86 Typical High $1,122.02 | Professional | None | $194.98 | $512.86 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $457.09 Typical High $794.33 | Facility | None | $95.50 | $457.09 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,047.13 | Professional | None | $602.56 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $134.90 Median $416.87 Typical High $1,096.48 | Professional | None | $134.90 | $416.87 | $1,096.48 |
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 $66.07 Median $263.03 Typical High $323.59 | Professional | 52 · Reduced service | $66.07 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $26.30 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $100.00 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $79.43 Typical High $97.72 | Professional | 55 · Aftercare only | $19.95 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $52.48 Typical High $64.57 | Professional | 56 · Pre-op care only | $13.18 | $52.48 | $64.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $512.86 Typical High $512.86 | Professional | 51 · Multiple procedures | $302.00 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $208.93 Typical High $208.93 | Professional | 80 · Assistant surgeon | $120.23 | $208.93 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $144.54 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $85.11 | $144.54 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $144.54 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $144.54 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $144.54 Typical High $144.54 | Professional | AS · PA/NP assist | $85.11 | $144.54 | $144.54 |
Where North Carolina sits
The same service costs 5.6 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $3,479MD $616
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.