How much rates vary
Facilitymedian $195 · 10th to 90th $100 to $692Professionalmedian $355 · 10th to 90th $182 to $603
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 $154.88 Median $257.04 Typical High $5,248.07 | Facility | None | $154.88 | $257.04 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $281.84 | Professional | None | $154.88 | $239.88 | $281.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $257.04 | Facility | None | $128.82 | $190.55 | $257.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $676.08 | Professional | None | $223.87 | $446.68 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $229.09 Typical High $371.54 | Facility | None | $56.23 | $229.09 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $501.19 | Professional | None | $173.78 | $245.47 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $616.60 | Professional | None | $354.81 | $354.81 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $354.81 | Facility | None | $125.89 | $181.97 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $446.68 | Professional | None | $251.19 | $263.03 | $446.68 |
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 $144.54 Median $239.88 Typical High $489.78 | Professional | None | $144.54 | $239.88 | $489.78 |
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 $77.62 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $114.82 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $22.91 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $23.99 | $25.70 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $57.54 Median $91.20 Typical High $162.18 | Facility | 51 · Multiple procedures | $57.54 | $91.20 | $162.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $131.83 Typical High $338.84 | Professional | 51 · Multiple procedures | $125.89 | $131.83 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $52.48 Typical High $134.90 | Professional | 80 · Assistant surgeon | $50.12 | $52.48 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $37.15 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $34.67 | $37.15 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $37.15 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $37.15 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $37.15 Typical High $93.33 | Professional | AS · PA/NP assist | $34.67 | $37.15 | $93.33 |
Where North Carolina sits
The same service costs 3.6 times more in Alaska 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.
North Carolina· 11th of 51
$355
AK $661MD $182
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.