How much rates vary
Facilitymedian $102 · 10th to 90th $62 to $468Professionalmedian $132 · 10th to 90th $85 to $263
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 $75.86 Median $75.86 Typical High $102.33 | Facility | None | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $102.33 | Professional | None | $75.86 | $95.50 | $102.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $48.98 Median $72.44 Typical High $97.72 | Facility | None | $48.98 | $72.44 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $281.84 | Professional | None | $102.33 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $114.82 Typical High $169.82 | Facility | None | $56.23 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $208.93 | Professional | None | $83.18 | $107.15 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $147.91 | Facility | None | $61.66 | $91.20 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $173.78 | Professional | None | $100.00 | $123.03 | $173.78 |
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 $70.79 Median $102.33 Typical High $208.93 | Professional | None | $70.79 | $102.33 | $208.93 |
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 $37.15 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $37.15 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.05 Typical High $20.42 | Professional | 53 · Discontinued | $15.14 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.13 Typical High $15.49 | Professional | 55 · Aftercare only | $11.22 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $10.23 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $87.10 Median $134.90 Typical High $223.87 | Facility | 50 · Both sides | $87.10 | $134.90 | $223.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $28.84 Median $45.71 Typical High $74.13 | Facility | 51 · Multiple procedures | $28.84 | $45.71 | $74.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $186.21 Typical High $380.19 | Professional | 50 · Both sides | $151.36 | $186.21 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $61.66 Typical High $128.82 | Professional | 51 · Multiple procedures | $50.12 | $61.66 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $24.55 Typical High $51.29 | Professional | 80 · Assistant surgeon | $19.95 | $24.55 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $17.38 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $14.13 | $17.38 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.13 Median $17.38 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $14.13 | $17.38 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $17.38 Typical High $35.48 | Professional | AS · PA/NP assist | $14.13 | $17.38 | $35.48 |
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· 15th of 51
$129
AK $309FL $81.28
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.