How much rates vary
Facilitymedian $107 · 10th to 90th $35 to $891Professionalmedian $60 · 10th to 90th $31 to $117
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 $18.20 Median $18.20 Typical High $34.67 | Facility | None | $18.20 | $18.20 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $37.15 | Professional | None | $18.20 | $31.62 | $37.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $28.84 Median $44.67 Typical High $114.82 | Facility | None | $28.84 | $44.67 | $114.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $120.23 | Professional | None | $42.66 | $72.44 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $74.13 | Professional | None | $33.11 | $52.48 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | None | $83.18 | $85.11 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $29.51 Median $51.29 Typical High $51.29 | Facility | None | $29.51 | $51.29 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $67.61 | Professional | None | $41.69 | $58.88 | $67.61 |
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 $18.62 Median $37.15 Typical High $74.13 | Professional | None | $18.62 | $37.15 | $74.13 |
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 $9.12 Median $15.49 Typical High $16.98 | Professional | 52 · Reduced service | $9.12 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $6.17 Typical High $6.92 | Professional | 53 · Discontinued | $3.63 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $4.68 Typical High $5.13 | Professional | 55 · Aftercare only | $2.75 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.09 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.82 | $3.09 | $3.47 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $89.13 Typical High $138.04 | Professional | 50 · Both sides | $69.18 | $89.13 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.91 Median $29.51 Typical High $45.71 | Professional | 51 · Multiple procedures | $22.91 | $29.51 | $45.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.33 Median $11.75 Typical High $18.20 | Professional | 80 · Assistant surgeon | $9.33 | $11.75 | $18.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.46 Median $8.32 Typical High $12.88 | Professional | 81 · Minimal assistant surgeon | $6.46 | $8.32 | $12.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.46 Median $8.32 Typical High $12.88 | Professional | 82 · Assistant surgeon, no resident | $6.46 | $8.32 | $12.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.46 Median $8.32 Typical High $12.88 | Professional | AS · PA/NP assist | $6.46 | $8.32 | $12.88 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 3rd of 51
$61.66
AK $91.20VA $23.99
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.