How much rates vary
Facilitymedian $891 · 10th to 90th $105 to $4,266Professionalmedian $186 · 10th to 90th $129 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 $104.71 Median $707.95 Typical High $7,943.28 | Facility | None | $104.71 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $194.98 | Professional | None | $95.50 | $104.71 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $95.50 | Professional | None | $58.88 | $75.86 | $95.50 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $331.13 | Professional | None | $134.90 | $208.93 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $263.03 | Professional | None | $114.82 | $131.83 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $229.09 | Professional | None | $128.82 | $144.54 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $275.42 | Professional | None | $100.00 | $138.04 | $275.42 |
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 $48.98 Median $52.48 Typical High $56.23 | Professional | 52 · Reduced service | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $77.62 Typical High $85.11 | Professional | 54 · Surgery only | $72.44 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.77 | $10.47 | $11.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $72.44 Typical High $154.88 | Professional | 51 · Multiple procedures | $69.18 | $72.44 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $28.84 Typical High $61.66 | Professional | 80 · Assistant surgeon | $27.54 | $28.84 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $19.95 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $19.05 | $19.95 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $19.95 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $19.95 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $19.95 Typical High $43.65 | Professional | AS · PA/NP assist | $19.05 | $19.95 | $43.65 |
Where North Carolina sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 10th of 51
$186
WI $316NY $89.13
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.