How much rates vary
Facilitymedian $204 · 10th to 90th $100 to $575Professionalmedian $263 · 10th to 90th $151 to $550
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 $131.83 Median $131.83 Typical High $213.80 | Facility | None | $131.83 | $131.83 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $218.78 | Professional | None | $131.83 | $199.53 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $275.42 | Facility | None | $138.04 | $204.17 | $275.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $575.44 | Professional | None | $181.97 | $302.00 | $575.44 |
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 $147.91 Median $213.80 Typical High $426.58 | Professional | None | $147.91 | $213.80 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | None | $309.03 | $309.03 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $323.59 | Facility | None | $125.89 | $181.97 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $371.54 | Professional | None | $208.93 | $245.47 | $371.54 |
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 $125.89 Median $208.93 Typical High $436.52 | Professional | None | $125.89 | $208.93 | $436.52 |
10 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 $66.07 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $66.07 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $26.30 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $21.88 |
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 $104.71 Median $123.03 Typical High $275.42 | Professional | 51 · Multiple procedures | $104.71 | $123.03 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $48.98 Typical High $109.65 | Professional | 80 · Assistant surgeon | $41.69 | $48.98 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $34.67 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $29.51 | $34.67 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $34.67 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $34.67 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $34.67 Typical High $77.62 | Professional | AS · PA/NP assist | $29.51 | $34.67 | $77.62 |
Where North Carolina sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.