How much rates vary
Facilitymedian $151 · 10th to 90th $72 to $794Professionalmedian $120 · 10th to 90th $72 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 $72.44 Median $151.36 Typical High $5,248.07 | Facility | None | $72.44 | $151.36 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $204.17 | Professional | None | $72.44 | $125.89 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $213.80 | Professional | None | $109.65 | $109.65 | $213.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $75.86 Median $117.49 Typical High $302.00 | Facility | None | $75.86 | $117.49 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $281.84 | Professional | None | $70.79 | $120.23 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $154.88 Typical High $251.19 | Facility | None | $56.23 | $154.88 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $263.03 | Professional | None | $79.43 | $114.82 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | None | $158.49 | $158.49 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $295.12 | Facility | None | $69.18 | $102.33 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $186.21 | Professional | None | $109.65 | $147.91 | $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 $66.07 Median $112.20 Typical High $245.47 | Professional | None | $66.07 | $112.20 | $245.47 |
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 $36.31 Median $48.98 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.95 Typical High $30.20 | Professional | 53 · Discontinued | $14.45 | $19.95 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $74.13 Typical High $114.82 | Professional | 54 · Surgery only | $53.70 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.79 Typical High $22.91 | Professional | 55 · Aftercare only | $10.72 | $14.79 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.00 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $10.00 | $15.14 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $33.11 Median $51.29 Typical High $144.54 | Facility | 51 · Multiple procedures | $33.11 | $51.29 | $144.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $74.13 Typical High $128.82 | Professional | 51 · Multiple procedures | $54.95 | $74.13 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $29.51 Typical High $51.29 | Professional | 80 · Assistant surgeon | $21.88 | $29.51 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $20.42 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $15.14 | $20.42 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $20.42 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $20.42 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $20.42 Typical High $35.48 | Professional | AS · PA/NP assist | $15.14 | $20.42 | $35.48 |
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· 43rd of 51
$120
AK $309KY $97.72
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.