How much rates vary
Facilitymedian $98 · 10th to 90th $51 to $891Professionalmedian $107 · 10th to 90th $59 to $234
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 $58.88 Median $134.90 Typical High $5,248.07 | Facility | None | $58.88 | $134.90 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $190.55 | Professional | None | $58.88 | $112.20 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $190.55 | Professional | None | $77.62 | $190.55 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $93.33 | Facility | None | $47.86 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $257.04 | Professional | None | $60.26 | $107.15 | $257.04 |
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 $69.18 Median $104.71 Typical High $213.80 | Professional | None | $69.18 | $104.71 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $331.13 | Facility | None | $43.65 | $69.18 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $165.96 | Professional | None | $97.72 | $128.82 | $165.96 |
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 $53.70 Median $100.00 Typical High $199.53 | Professional | None | $53.70 | $100.00 | $199.53 |
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 $29.51 Median $42.66 Typical High $67.61 | Professional | 52 · Reduced service | $29.51 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.98 Typical High $26.92 | Professional | 53 · Discontinued | $11.75 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $64.57 Typical High $102.33 | Professional | 54 · Surgery only | $43.65 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.88 Typical High $20.42 | Professional | 55 · Aftercare only | $8.71 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.51 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.89 | $8.51 | $13.49 |
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 $48.98 Median $64.57 Typical High $112.20 | Professional | 51 · Multiple procedures | $48.98 | $64.57 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $25.70 Typical High $44.67 | Professional | 80 · Assistant surgeon | $19.50 | $25.70 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $18.20 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $13.80 | $18.20 | $31.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $18.20 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $18.20 | $31.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $18.20 Typical High $31.62 | Professional | AS · PA/NP assist | $13.80 | $18.20 | $31.62 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 42nd of 51
$105
AK $302NJ $85.11
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.