How much rates vary
Facilitymedian $776 · 10th to 90th $282 to $4,898Professionalmedian $380 · 10th to 90th $224 to $617
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 $194.98 Median $194.98 Typical High $7,943.28 | Facility | None | $194.98 | $194.98 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | None | $194.98 | $194.98 | $275.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $616.60 | Professional | None | $288.40 | $446.68 | $616.60 |
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 $251.19 Median $288.40 Typical High $575.44 | Professional | None | $251.19 | $288.40 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $229.09 Typical High $870.96 | Facility | None | $194.98 | $229.09 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $389.05 | Professional | None | $204.17 | $275.42 | $389.05 |
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 $199.53 Median $302.00 Typical High $537.03 | Professional | None | $199.53 | $302.00 | $537.03 |
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 $95.50 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $38.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $24.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $141.25 Typical High $281.84 | Professional | 51 · Multiple procedures | $102.33 | $141.25 | $281.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $56.23 Typical High $114.82 | Professional | 80 · Assistant surgeon | $40.74 | $56.23 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $38.90 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $28.84 | $38.90 | $79.43 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $38.90 Typical High $79.43 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $38.90 | $79.43 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $38.90 Typical High $79.43 | Professional | AS · PA/NP assist | $28.84 | $38.90 | $79.43 |
Where North Carolina sits
The same service costs 43.4 times more in Alabama 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
AL $25,986MT $598
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.