How much rates vary
Facilitymedian $224 · 10th to 90th $81 to $1,995Professionalmedian $229 · 10th to 90th $135 to $398
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 $128.82 Median $1,000.00 Typical High $7,943.28 | Facility | None | $128.82 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $870.96 | Professional | None | $128.82 | $128.82 | $870.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $407.38 | Professional | None | $186.21 | $309.03 | $407.38 |
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 $165.96 Median $194.98 Typical High $398.11 | Professional | None | $165.96 | $194.98 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $208.93 | Facility | None | $128.82 | $128.82 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $208.93 | Professional | None | $123.03 | $169.82 | $208.93 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $354.81 | Professional | None | $134.90 | $208.93 | $354.81 |
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 $64.57 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $25.70 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $85.11 Typical High $177.83 | Professional | 51 · Multiple procedures | $61.66 | $85.11 | $177.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $33.88 Typical High $70.79 | Professional | 80 · Assistant surgeon | $24.55 | $33.88 | $70.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $23.99 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $17.38 | $23.99 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $23.99 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $23.99 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $23.99 Typical High $50.12 | Professional | AS · PA/NP assist | $17.38 | $23.99 | $50.12 |
Where North Carolina sits
The same service costs 49.9 times more in Alabama than in Kentucky. 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
AL $14,973KY $300
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.