How much rates vary
Facilitymedian $28,184 · 10th to 90th $617 to $63,096Professionalmedian $550 · 10th to 90th $331 to $1,000
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 $323.59 Median $1,288.25 Typical High $11,481.54 | Facility | None | $323.59 | $1,288.25 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $1,288.25 | Professional | None | $323.59 | $323.59 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $24,547.09 Median $40,738.03 Typical High $63,095.73 | Facility | None | $24,547.09 | $40,738.03 | $63,095.73 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $1,023.29 | Professional | None | $436.52 | $758.58 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $977.24 | Professional | None | $407.38 | $478.63 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $28,183.83 Typical High $93,325.43 | Facility | None | $323.59 | $28,183.83 | $93,325.43 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $524.81 | Professional | None | $309.03 | $457.09 | $524.81 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $28,183.83 Typical High $74,131.02 | Facility | None | $2,344.23 | $28,183.83 | $74,131.02 |
United Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $891.25 | Professional | None | $331.13 | $512.86 | $891.25 |
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 $162.18 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $162.18 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $245.47 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $37.15 |
Ambetter Setting Professional Modifier Q0 · Research study, investigational Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | Q0 · Research study, investigational | $407.38 | $407.38 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $223.87 Typical High $467.74 | Professional | 51 · Multiple procedures | $154.88 | $223.87 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $91.20 Typical High $186.21 | Professional | 80 · Assistant surgeon | $61.66 | $91.20 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $63.10 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $42.66 | $63.10 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $63.10 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $63.10 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $63.10 Typical High $131.83 | Professional | AS · PA/NP assist | $42.66 | $63.10 | $131.83 |
Where North Carolina sits
The same service costs 45.0 times more in New Mexico 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
NM $44,130MT $980
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.