How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $5,495Professionalmedian $1,023 · 10th to 90th $457 to $1,445
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 $380.19 Median $1,584.89 Typical High $10,964.78 | Facility | None | $380.19 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,584.89 | Professional | None | $380.19 | $380.19 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,348.96 Typical High $1,479.11 | Professional | None | $776.25 | $1,348.96 | $1,479.11 |
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 $549.54 Median $776.25 Typical High $1,318.26 | Professional | None | $549.54 | $776.25 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $1,230.27 | Facility | None | $380.19 | $457.09 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $831.76 Typical High $912.01 | Professional | None | $363.08 | $831.76 | $912.01 |
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 $407.38 Median $758.58 Typical High $1,258.93 | Professional | None | $407.38 | $758.58 | $1,258.93 |
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 $190.55 Median $190.55 Typical High $245.47 | Professional | 52 · Reduced service | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $288.40 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $48.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $1,258.93 Typical High $1,737.80 | Professional | 50 · Both sides | $537.03 | $1,258.93 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $416.87 Typical High $575.44 | Professional | 51 · Multiple procedures | $177.83 | $416.87 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $72.44 | $165.96 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $117.49 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $50.12 | $117.49 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $117.49 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $117.49 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $50.12 | $117.49 | $162.18 |
Where North Carolina sits
The same service costs 3.7 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· 5th of 51
$1,000
WI $1,622NY $437
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.