How much rates vary
Facilitymedian $251 · 10th to 90th $76 to $1,000Professionalmedian $85 · 10th to 90th $21 to $191
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 $75.86 Median $75.86 Typical High $7,943.28 | Facility | None | $75.86 | $75.86 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | None | $75.86 | $75.86 | $85.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $21.38 Median $79.43 Typical High $190.55 | Professional | None | $21.38 | $79.43 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $602.56 Typical High $954.99 | Facility | None | $56.23 | $602.56 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $169.82 | Professional | None | $81.28 | $85.11 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $501.19 | Facility | None | $66.07 | $102.33 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $223.87 | Professional | None | $74.13 | $93.33 | $223.87 |
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 $61.66 Median $74.13 Typical High $181.97 | Professional | None | $61.66 | $74.13 | $181.97 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 54 · Surgery only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $33.11 Median $51.29 Typical High $331.13 | Facility | 51 · Multiple procedures | $33.11 | $51.29 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $46.77 Typical High $112.20 | Professional | 51 · Multiple procedures | $37.15 | $46.77 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $18.62 Typical High $44.67 | Professional | 80 · Assistant surgeon | $14.79 | $18.62 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $13.18 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $10.23 | $13.18 | $30.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $13.18 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $13.18 | $30.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $13.18 Typical High $30.90 | Professional | AS · PA/NP assist | $10.23 | $13.18 | $30.90 |
Where North Carolina sits
The same service costs 5.5 times more in Arkansas 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· 40th of 51
$87.10
AR $331KY $60.26
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.