How much rates vary
Facilitymedian $851 · 10th to 90th $251 to $3,162Professionalmedian $676 · 10th to 90th $200 to $1,514
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 $151.36 Median $501.19 Typical High $2,041.74 | Facility | None | $151.36 | $501.19 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $446.68 Typical High $707.95 | Professional | None | $151.36 | $446.68 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $489.78 | Professional | None | $154.88 | $407.38 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,238.72 | Facility | None | $524.81 | $724.44 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $275.42 Median $1,047.13 Typical High $1,621.81 | Professional | None | $275.42 | $1,047.13 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,949.84 | Facility | None | $602.56 | $1,174.90 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $660.69 Typical High $1,122.02 | Professional | None | $208.93 | $660.69 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $602.56 Typical High $1,479.11 | Facility | None | $245.47 | $602.56 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,023.29 | Professional | None | $575.44 | $891.25 | $1,023.29 |
Oscar Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $158.49 Median $512.86 Typical High $1,174.90 | Professional | None | $158.49 | $512.86 | $1,174.90 |
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 $75.86 Median $100.00 Typical High $251.19 | Professional | 52 · Reduced service | $75.86 | $100.00 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $100.00 | Professional | 53 · Discontinued | $30.20 | $39.81 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $151.36 Typical High $380.19 | Professional | 54 · Surgery only | $114.82 | $151.36 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $75.86 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $50.12 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $50.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,318.26 Typical High $2,187.76 | Professional | 50 · Both sides | $851.14 | $1,318.26 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $446.68 Typical High $724.44 | Professional | 51 · Multiple procedures | $281.84 | $446.68 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $177.83 Typical High $288.40 | Professional | 80 · Assistant surgeon | $114.82 | $177.83 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $79.43 Median $123.03 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $79.43 | $123.03 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $79.43 Median $123.03 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $79.43 | $123.03 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $123.03 Typical High $204.17 | Professional | AS · PA/NP assist | $79.43 | $123.03 | $204.17 |
Where North Carolina sits
The same service costs 4.5 times more in Colorado 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
CO $4,866MD $1,088
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.