How much rates vary
Facilitymedian $126 · 10th to 90th $48 to $1,096Professionalmedian $240 · 10th to 90th $105 to $468
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 $102.33 Median $138.04 Typical High $7,413.10 | Facility | None | $102.33 | $138.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $346.74 | Professional | None | $102.33 | $138.04 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $223.87 | Professional | None | $104.71 | $123.03 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $54.95 Typical High $141.25 | Facility | None | $35.48 | $54.95 | $141.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $501.19 | Professional | None | $134.90 | $302.00 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $389.05 | Professional | None | $151.36 | $239.88 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | None | $363.08 | $363.08 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $47.86 Typical High $162.18 | Facility | None | $30.20 | $47.86 | $162.18 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $288.40 | Professional | None | $134.90 | $239.88 | $288.40 |
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 $97.72 Median $186.21 Typical High $346.74 | Professional | None | $97.72 | $186.21 | $346.74 |
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 $51.29 Median $67.61 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $13.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $15.14 Median $23.99 Typical High $51.29 | Facility | 51 · Multiple procedures | $15.14 | $23.99 | $51.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $144.54 Typical High $144.54 | Professional | 51 · Multiple procedures | $67.61 | $144.54 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $57.54 Typical High $57.54 | Professional | 80 · Assistant surgeon | $38.90 | $57.54 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $26.92 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $40.74 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $40.74 Typical High $40.74 | Professional | AS · PA/NP assist | $26.92 | $40.74 | $40.74 |
Where North Carolina sits
The same service costs 11.5 times more in Connecticut than in Maryland. 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.
Physician feeFacility fee
CT $2,992MD $261
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.