How much rates vary
Facilitymedian $832 · 10th to 90th $282 to $7,244Professionalmedian $562 · 10th to 90th $269 to $871
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 $229.09 Median $229.09 Typical High $7,943.28 | Facility | None | $229.09 | $229.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $933.25 | Professional | None | $426.58 | $691.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $707.95 | Professional | None | $295.12 | $338.84 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $239.88 Typical High $371.54 | Facility | None | $229.09 | $239.88 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $380.19 | Professional | None | $218.78 | $331.13 | $380.19 |
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 $234.42 Median $371.54 Typical High $630.96 | Professional | None | $234.42 | $371.54 | $630.96 |
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 $114.82 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $29.51 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 58 · Staged procedure | $229.09 | $229.09 | $229.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $165.96 Typical High $338.84 | Professional | 51 · Multiple procedures | $109.65 | $165.96 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $66.07 Typical High $134.90 | Professional | 80 · Assistant surgeon | $43.65 | $66.07 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $45.71 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $30.20 | $45.71 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $45.71 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $45.71 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $45.71 Typical High $95.50 | Professional | AS · PA/NP assist | $30.20 | $45.71 | $95.50 |
Where North Carolina sits
The same service costs 7.3 times more in Alaska 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
AK $5,199MT $710
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.