How much rates vary
Facilitymedian $851 · 10th to 90th $389 to $5,248Professionalmedian $1,175 · 10th to 90th $832 to $2,188
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 $724.44 Median $1,000.00 Typical High $12,022.64 | Facility | None | $724.44 | $1,000.00 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,000.00 | Professional | None | $724.44 | $724.44 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,187.76 | Professional | None | $912.01 | $1,412.54 | $2,187.76 |
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 $954.99 Median $1,071.52 Typical High $2,238.72 | Professional | None | $954.99 | $1,071.52 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $1,412.54 | Facility | None | $741.31 | $1,412.54 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,258.93 | Professional | None | $724.44 | $1,000.00 | $1,258.93 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,949.84 | Professional | None | $741.31 | $1,174.90 | $1,949.84 |
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 $363.08 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $91.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $501.19 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $363.08 | $501.19 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $199.53 Typical High $416.87 | Professional | 80 · Assistant surgeon | $144.54 | $199.53 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $141.25 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $102.33 | $141.25 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $141.25 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $141.25 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $141.25 Typical High $295.12 | Professional | AS · PA/NP assist | $102.33 | $141.25 | $295.12 |
Where North Carolina sits
The same service costs 3.8 times more in Wisconsin 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· 18th of 51
$1,148
WI $2,951NY $776
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.