How much rates vary
Facilitymedian $115 · 10th to 90th $52 to $617Professionalmedian $81 · 10th to 90th $44 to $195
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 $44.67 Median $114.82 Typical High $1,584.89 | Facility | None | $44.67 | $114.82 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $158.49 | Professional | None | $44.67 | $85.11 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $154.88 | Professional | None | $81.28 | $81.28 | $154.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $93.33 | Facility | None | $46.77 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $204.17 | Professional | None | $42.66 | $83.18 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $134.90 Typical High $204.17 | Facility | None | $56.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $169.82 | Professional | None | $47.86 | $81.28 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | None | $97.72 | $97.72 | $112.20 |
Medcost Setting Facility Modifier None Typical Low $44.67 Median $70.79 Typical High $223.87 | Facility | None | $44.67 | $70.79 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $154.88 | Professional | None | $75.86 | $102.33 | $154.88 |
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 $38.90 Median $77.62 Typical High $158.49 | Professional | None | $38.90 | $77.62 | $158.49 |
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 $22.39 Median $32.36 Typical High $56.23 | Professional | 52 · Reduced service | $22.39 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.88 Typical High $22.91 | Professional | 53 · Discontinued | $8.91 | $12.88 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $48.98 Typical High $85.11 | Professional | 54 · Surgery only | $33.11 | $48.98 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.77 Typical High $16.98 | Professional | 55 · Aftercare only | $6.61 | $9.77 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.46 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.47 | $6.46 | $11.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $23.44 Median $33.88 Typical High $112.20 | Facility | 51 · Multiple procedures | $23.44 | $33.88 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $51.29 Typical High $77.62 | Professional | 51 · Multiple procedures | $38.02 | $51.29 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $20.42 Typical High $36.31 | Professional | 80 · Assistant surgeon | $15.14 | $20.42 | $36.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.72 Median $14.13 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $10.72 | $14.13 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.72 Median $14.13 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $10.72 | $14.13 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $14.13 Typical High $25.70 | Professional | AS · PA/NP assist | $10.72 | $14.13 | $25.70 |
Where North Carolina sits
The same service costs 3.5 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· 46th of 51
$83.18
AK $229KY $66.07
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.