How much rates vary
Facilitymedian $107 · 10th to 90th $68 to $676Professionalmedian $117 · 10th to 90th $71 to $240
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 $67.61 Median $95.50 Typical High $5,248.07 | Facility | None | $67.61 | $95.50 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $100.00 | Professional | None | $67.61 | $87.10 | $100.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $114.82 | Facility | None | $56.23 | $85.11 | $114.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $257.04 | Professional | None | $74.13 | $134.90 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $128.82 Typical High $190.55 | Facility | None | $56.23 | $128.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $190.55 | Professional | None | $66.07 | $97.72 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $223.87 | Professional | None | $141.25 | $141.25 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $169.82 | Facility | None | $61.66 | $91.20 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $162.18 | Professional | None | $93.33 | $104.71 | $162.18 |
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 $93.33 Typical High $194.98 | Professional | None | $61.66 | $93.33 | $194.98 |
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 $33.88 Median $42.66 Typical High $47.86 | Professional | 52 · Reduced service | $33.88 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $13.49 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $64.57 Typical High $70.79 | Professional | 54 · Surgery only | $50.12 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.76 | $8.51 | $9.55 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $85.11 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $52.48 Typical High $120.23 | Professional | 51 · Multiple procedures | $46.77 | $52.48 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $20.89 Typical High $48.98 | Professional | 80 · Assistant surgeon | $18.62 | $20.89 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $14.79 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $13.18 | $14.79 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $14.79 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $14.79 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $14.79 Typical High $33.88 | Professional | AS · PA/NP assist | $13.18 | $14.79 | $33.88 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$117
AK $282FL $74.13
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.