How much rates vary
Facilitymedian $1,000 · 10th to 90th $288 to $3,236Professionalmedian $437 · 10th to 90th $214 to $776
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 $162.18 Median $245.47 Typical High $5,248.07 | Facility | None | $162.18 | $245.47 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $398.11 | Professional | None | $162.18 | $245.47 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $281.84 | Professional | None | $112.20 | $151.36 | $281.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $4,570.88 | Facility | None | $1,148.15 | $1,778.28 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $851.14 | Professional | None | $295.12 | $489.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,659.59 | Facility | None | $457.09 | $1,318.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $562.34 | Professional | None | $229.09 | $363.08 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $602.56 Typical High $1,621.81 | Facility | None | $288.40 | $602.56 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $478.63 | Professional | None | $295.12 | $407.38 | $478.63 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $562.34 | Professional | None | $165.96 | $295.12 | $562.34 |
13 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 $81.28 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $24.55 | $27.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,258.93 Typical High $2,398.83 | Facility | 50 · Both sides | $562.34 | $1,258.93 | $2,398.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $416.87 Typical High $812.83 | Facility | 51 · Multiple procedures | $186.21 | $416.87 | $812.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $616.60 Typical High $1,047.13 | Professional | 50 · Both sides | $489.78 | $616.60 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $204.17 Typical High $346.74 | Professional | 51 · Multiple procedures | $165.96 | $204.17 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $81.28 Typical High $138.04 | Professional | 80 · Assistant surgeon | $66.07 | $81.28 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $45.71 | $57.54 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $57.54 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | AS · PA/NP assist | $45.71 | $57.54 | $97.72 |
Where North Carolina sits
The same service costs 3.1 times more in Alaska than in New York. 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· 5th of 51
$468
AK $794NY $257
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.