How much rates vary
Facilitymedian $110 · 10th to 90th $47 to $1,000Professionalmedian $66 · 10th to 90th $32 to $158
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 $33.11 Median $97.72 Typical High $1,584.89 | Facility | None | $33.11 | $97.72 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $67.61 Typical High $131.83 | Professional | None | $33.11 | $67.61 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $134.90 | Professional | None | $70.79 | $123.03 | $134.90 |
BCBS Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $190.55 | Facility | None | $47.86 | $74.13 | $190.55 |
BCBS Setting Professional Modifier None Typical Low $30.20 Median $63.10 Typical High $169.82 | Professional | None | $30.20 | $63.10 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $66.07 Typical High $147.91 | Professional | None | $33.11 | $66.07 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | None | $70.79 | $70.79 | $89.13 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $208.93 | Facility | None | $43.65 | $69.18 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $134.90 | Professional | None | $61.66 | $81.28 | $134.90 |
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 $28.18 Median $63.10 Typical High $138.04 | Professional | None | $28.18 | $63.10 | $138.04 |
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 $16.60 Median $25.70 Typical High $50.12 | Professional | 52 · Reduced service | $16.60 | $25.70 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $10.23 Typical High $19.95 | Professional | 53 · Discontinued | $6.61 | $10.23 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $38.90 Typical High $74.13 | Professional | 54 · Surgery only | $25.12 | $38.90 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.76 Typical High $14.79 | Professional | 55 · Aftercare only | $5.01 | $7.76 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.31 | $5.13 | $10.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $21.88 Median $33.88 Typical High $33.88 | Facility | 51 · Multiple procedures | $21.88 | $33.88 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $40.74 Typical High $77.62 | Professional | 51 · Multiple procedures | $30.90 | $40.74 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $16.22 Typical High $30.90 | Professional | 80 · Assistant surgeon | $12.30 | $16.22 | $30.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.71 Median $11.48 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $8.71 | $11.48 | $21.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.71 Median $11.48 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $8.71 | $11.48 | $21.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.71 Median $11.48 Typical High $21.88 | Professional | AS · PA/NP assist | $8.71 | $11.48 | $21.88 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 45th of 51
$66.07
AK $170KY $51.29
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.