How much rates vary
Facilitymedian $6,761 · 10th to 90th $851 to $12,589Professionalmedian $692 · 10th to 90th $468 to $1,413
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 $467.74 Median $1,288.25 Typical High $8,317.64 | Facility | None | $467.74 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | None | $467.74 | $467.74 | $575.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,760.83 Median $10,000.00 Typical High $13,489.63 | Facility | None | $6,760.83 | $10,000.00 | $13,489.63 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $977.24 Typical High $1,445.44 | Professional | None | $467.74 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $12,302.69 | Facility | None | $602.56 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,258.93 | Professional | None | $562.34 | $660.69 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $4,168.69 Typical High $8,709.64 | Facility | None | $489.78 | $4,168.69 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $794.33 | Professional | None | $562.34 | $676.08 | $794.33 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,122.02 | Professional | None | $467.74 | $616.60 | $1,122.02 |
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 $234.42 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $56.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $338.84 Typical High $676.08 | Professional | 51 · Multiple procedures | $316.23 | $338.84 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $134.90 Typical High $269.15 | Professional | 80 · Assistant surgeon | $125.89 | $134.90 | $269.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $93.33 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $87.10 | $93.33 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $93.33 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $93.33 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $93.33 Typical High $190.55 | Professional | AS · PA/NP assist | $87.10 | $93.33 | $190.55 |
Where North Carolina sits
The same service costs 3.9 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· 23rd of 51
$794
AK $1,905NY $490
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.