How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $5,623Professionalmedian $219 · 10th to 90th $148 to $427
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 $138.04 Median $239.88 Typical High $7,943.28 | Facility | None | $138.04 | $239.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $257.04 | Professional | None | $138.04 | $138.04 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $4,570.88 | Facility | None | $1,148.15 | $1,819.70 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $436.52 | Professional | None | $181.97 | $295.12 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,388.44 | Facility | None | $602.56 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $380.19 | Professional | None | $165.96 | $199.53 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $2,344.23 | Facility | None | $446.68 | $977.24 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $309.03 | Professional | None | $165.96 | $186.21 | $309.03 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $346.74 | Professional | None | $141.25 | $181.97 | $346.74 |
11 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 $69.18 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $28.18 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.98 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $616.60 Typical High $1,584.89 | Facility | 51 · Multiple procedures | $257.04 | $616.60 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $93.33 Typical High $204.17 | Professional | 51 · Multiple procedures | $89.13 | $93.33 | $204.17 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $37.15 Typical High $81.28 | Professional | 80 · Assistant surgeon | $35.48 | $37.15 | $81.28 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $26.30 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $25.12 | $26.30 | $56.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $26.30 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $26.30 | $56.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $26.30 Typical High $56.23 | Professional | AS · PA/NP assist | $25.12 | $26.30 | $56.23 |
Where North Carolina sits
The same service costs 14.3 times more in Colorado than in Montana. 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
CO $6,102MT $428
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.