How much rates vary
Facilitymedian $123 · 10th to 90th $69 to $891Professionalmedian $145 · 10th to 90th $69 to $269
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 $69.18 Median $147.91 Typical High $5,248.07 | Facility | None | $69.18 | $147.91 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $223.87 | Professional | None | $69.18 | $134.90 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $208.93 | Professional | None | $93.33 | $208.93 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $117.49 Typical High $158.49 | Facility | None | $81.28 | $117.49 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $147.91 Typical High $302.00 | Professional | None | $70.79 | $147.91 | $302.00 |
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 $79.43 Median $125.89 Typical High $251.19 | Professional | None | $79.43 | $125.89 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | None | $173.78 | $173.78 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $165.96 | Facility | None | $66.07 | $102.33 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $181.97 | Professional | None | $117.49 | $158.49 | $181.97 |
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 $64.57 Median $112.20 Typical High $239.88 | Professional | None | $64.57 | $112.20 | $239.88 |
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 $34.67 Median $50.12 Typical High $74.13 | Professional | 52 · Reduced service | $34.67 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $29.51 | Professional | 53 · Discontinued | $13.80 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $75.86 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $22.39 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.00 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.92 | $10.00 | $14.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $58.88 Median $79.43 Typical High $97.72 | Professional | 51 · Multiple procedures | $58.88 | $79.43 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $31.62 Typical High $50.12 | Professional | 80 · Assistant surgeon | $23.44 | $31.62 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.60 Median $21.88 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $16.60 | $21.88 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.60 Median $21.88 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $16.60 | $21.88 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $21.88 Typical High $34.67 | Professional | AS · PA/NP assist | $16.60 | $21.88 | $34.67 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska 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.
North Carolina· 19th of 51
$145
AK $355MD $100
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.