How much rates vary
Facilitymedian $117 · 10th to 90th $50 to $1,175Professionalmedian $63 · 10th to 90th $28 to $132
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 $28.18 Median $57.54 Typical High $7,413.10 | Facility | None | $28.18 | $57.54 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $102.33 | Professional | None | $28.18 | $57.54 | $102.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $165.96 | Facility | None | $41.69 | $64.57 | $165.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $144.54 | Professional | None | $30.20 | $72.44 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $870.96 | Facility | None | $50.12 | $50.12 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $100.00 | Professional | None | $34.67 | $67.61 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | None | $100.00 | $100.00 | $112.20 |
Medcost Setting Facility Modifier None Typical Low $33.88 Median $74.13 Typical High $74.13 | Facility | None | $33.88 | $74.13 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $72.44 | Professional | None | $37.15 | $72.44 | $72.44 |
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 $26.92 Median $51.29 Typical High $95.50 | Professional | None | $26.92 | $51.29 | $95.50 |
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 $14.13 Median $23.44 Typical High $28.84 | Professional | 52 · Reduced service | $14.13 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $9.33 Typical High $11.48 | Professional | 53 · Discontinued | $5.75 | $9.33 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $35.48 Typical High $43.65 | Professional | 54 · Surgery only | $21.38 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.08 Typical High $8.71 | Professional | 55 · Aftercare only | $4.27 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.68 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.82 | $4.68 | $5.75 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $36.31 Typical High $48.98 | Professional | 51 · Multiple procedures | $18.62 | $36.31 | $48.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $14.45 Typical High $19.50 | Professional | 80 · Assistant surgeon | $7.41 | $14.45 | $19.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.13 Median $10.23 Typical High $13.80 | Professional | 81 · Minimal assistant surgeon | $5.13 | $10.23 | $13.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.13 Median $10.23 Typical High $13.80 | Professional | 82 · Assistant surgeon, no resident | $5.13 | $10.23 | $13.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.13 Median $10.23 Typical High $13.80 | Professional | AS · PA/NP assist | $5.13 | $10.23 | $13.80 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 20th of 51
$64.57
AK $148TX $37.15
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.