How much rates vary
Facilitymedian $209 · 10th to 90th $98 to $794Professionalmedian $347 · 10th to 90th $209 to $692
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 $181.97 Median $302.00 Typical High $5,248.07 | Facility | None | $181.97 | $302.00 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $309.03 | Professional | None | $181.97 | $251.19 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $562.34 | Facility | None | $141.25 | $218.78 | $562.34 |
BCBS North Carolina Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $776.25 | Professional | None | $251.19 | $407.38 | $776.25 |
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 $204.17 Median $257.04 Typical High $562.34 | Professional | None | $204.17 | $257.04 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $707.95 | Professional | None | $371.54 | $371.54 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $407.38 | Facility | None | $125.89 | $181.97 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $524.81 | Professional | None | $269.15 | $331.13 | $524.81 |
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 $169.82 Median $275.42 Typical High $562.34 | Professional | None | $169.82 | $275.42 | $562.34 |
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 $91.20 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $91.20 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $36.31 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $134.90 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $30.20 |
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 $134.90 Median $165.96 Typical High $389.05 | Professional | 51 · Multiple procedures | $134.90 | $165.96 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $66.07 Typical High $154.88 | Professional | 80 · Assistant surgeon | $53.70 | $66.07 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.02 Median $45.71 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $38.02 | $45.71 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.02 Median $45.71 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $38.02 | $45.71 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $45.71 Typical High $109.65 | Professional | AS · PA/NP assist | $38.02 | $45.71 | $109.65 |
Where North Carolina sits
The same service costs 3.8 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· 16th of 51
$339
AK $759MD $200
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.