How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $7,244Professionalmedian $1,380 · 10th to 90th $891 to $2,291
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 $758.58 Median $758.58 Typical High $7,943.28 | Facility | None | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,659.59 | $2,290.87 |
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 $954.99 Median $1,122.02 Typical High $2,344.23 | Professional | None | $954.99 | $1,122.02 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $1,202.26 | Facility | None | $758.58 | $794.33 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,230.27 | Professional | None | $707.95 | $1,071.52 | $1,230.27 |
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 $776.25 Median $1,202.26 Typical High $2,041.74 | Professional | None | $776.25 | $1,202.26 | $2,041.74 |
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 $380.19 Median $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $95.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $537.03 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $354.81 | $537.03 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $213.80 Typical High $436.52 | Professional | 80 · Assistant surgeon | $141.25 | $213.80 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $151.36 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $100.00 | $151.36 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $151.36 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $151.36 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $151.36 Typical High $309.03 | Professional | AS · PA/NP assist | $100.00 | $151.36 | $309.03 |
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· 12th of 51
$1,380
WI $3,090NY $813
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.