How much rates vary
Facilitymedian $135 · 10th to 90th $60 to $794Professionalmedian $105 · 10th to 90th $60 to $219
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 $60.26 Median $134.90 Typical High $5,248.07 | Facility | None | $60.26 | $134.90 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $181.97 | Professional | None | $60.26 | $114.82 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Professional | None | $95.50 | $95.50 | $186.21 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $190.55 | Facility | None | $47.86 | $74.13 | $190.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $245.47 | Professional | None | $61.66 | $104.71 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $147.91 Typical High $223.87 | Facility | None | $56.23 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $204.17 | Professional | None | $70.79 | $102.33 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | None | $128.82 | $128.82 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $245.47 | Facility | None | $46.77 | $69.18 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $186.21 | Professional | None | $95.50 | $128.82 | $186.21 |
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 $56.23 Median $97.72 Typical High $194.98 | Professional | None | $56.23 | $97.72 | $194.98 |
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 $30.20 Median $41.69 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $61.66 Typical High $100.00 | Professional | 54 · Surgery only | $45.71 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $13.49 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $21.88 Median $33.88 Typical High $123.03 | Facility | 51 · Multiple procedures | $21.88 | $33.88 | $123.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $64.57 Typical High $93.33 | Professional | 51 · Multiple procedures | $47.86 | $64.57 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $25.70 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.05 | $25.70 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $18.20 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $13.18 | $18.20 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $18.20 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $18.20 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $18.20 Typical High $25.70 | Professional | AS · PA/NP assist | $13.18 | $18.20 | $25.70 |
Where North Carolina sits
The same service costs 3.2 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· 42nd of 51
$105
AK $275KY $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.