How much rates vary
Facilitymedian $269 · 10th to 90th $98 to $1,862Professionalmedian $158 · 10th to 90th $91 to $316
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 $91.20 Median $141.25 Typical High $7,413.10 | Facility | None | $91.20 | $141.25 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $190.55 | Professional | None | $91.20 | $141.25 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
BCBS North Carolina Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $288.40 | Facility | None | $72.44 | $114.82 | $288.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $338.84 | Professional | None | $97.72 | $186.21 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $144.54 Typical High $524.81 | Facility | None | $93.33 | $144.54 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $288.40 | Professional | None | $114.82 | $158.49 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $204.17 | Facility | None | $89.13 | $128.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $194.98 | Professional | None | $134.90 | $177.83 | $194.98 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $263.03 | Professional | None | $87.10 | $131.83 | $263.03 |
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 $45.71 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $45.71 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $18.20 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $69.18 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $14.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $41.69 Median $64.57 Typical High $102.33 | Facility | 51 · Multiple procedures | $41.69 | $64.57 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $89.13 Typical High $112.20 | Professional | 51 · Multiple procedures | $67.61 | $89.13 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $36.31 Typical High $45.71 | Professional | 80 · Assistant surgeon | $27.54 | $36.31 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $25.12 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $19.05 | $25.12 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $25.12 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $25.12 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $25.12 Typical High $32.36 | Professional | AS · PA/NP assist | $19.05 | $25.12 | $32.36 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 21st of 51
$158
AK $372FL $117
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.