How much rates vary
Facilitymedian $117 · 10th to 90th $66 to $468Professionalmedian $151 · 10th to 90th $95 to $302
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 $81.28 Median $81.28 Typical High $117.49 | Facility | None | $81.28 | $81.28 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $123.03 | Professional | None | $81.28 | $114.82 | $123.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $102.33 | Facility | None | $51.29 | $75.86 | $102.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $323.59 | Professional | None | $97.72 | $177.83 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $134.90 Typical High $204.17 | Facility | None | $56.23 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $251.19 | Professional | None | $93.33 | $131.83 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | None | $190.55 | $190.55 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $177.83 | Facility | None | $81.28 | $123.03 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $199.53 | Professional | None | $114.82 | $141.25 | $199.53 |
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 $75.86 Median $117.49 Typical High $251.19 | Professional | None | $75.86 | $117.49 | $251.19 |
12 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 $39.81 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.91 Typical High $24.55 | Professional | 53 · Discontinued | $16.22 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.38 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.48 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $11.48 | $12.30 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $117.49 Median $181.97 Typical High $263.03 | Facility | 50 · Both sides | $117.49 | $181.97 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $38.90 Median $61.66 Typical High $89.13 | Facility | 51 · Multiple procedures | $38.90 | $61.66 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $213.80 Typical High $446.68 | Professional | 50 · Both sides | $173.78 | $213.80 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $70.79 Typical High $147.91 | Professional | 51 · Multiple procedures | $57.54 | $70.79 | $147.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $28.18 Typical High $58.88 | Professional | 80 · Assistant surgeon | $22.91 | $28.18 | $58.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $19.95 Typical High $41.69 | Professional | 81 · Minimal assistant surgeon | $16.22 | $19.95 | $41.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $19.95 Typical High $41.69 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $19.95 | $41.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $19.95 Typical High $41.69 | Professional | AS · PA/NP assist | $16.22 | $19.95 | $41.69 |
Where North Carolina sits
The same service costs 3.5 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
$145
AK $339MD $95.50
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.