How much rates vary
Facilitymedian $417 · 10th to 90th $47 to $2,455Professionalmedian $269 · 10th to 90th $76 to $891
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 $46.77 Median $257.04 Typical High $5,248.07 | Facility | None | $46.77 | $257.04 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $257.04 Typical High $426.58 | Professional | None | $46.77 | $257.04 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $295.12 Typical High $912.01 | Professional | None | $97.72 | $295.12 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $223.87 Typical High $588.84 | Professional | None | $56.23 | $223.87 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $269.15 | Facility | None | $46.77 | $46.77 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $602.56 | Professional | None | $141.25 | $426.58 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $47.86 Median $257.04 Typical High $602.56 | Professional | None | $47.86 | $257.04 | $602.56 |
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 $23.44 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $23.44 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $46.77 Typical High $64.57 | Professional | 53 · Discontinued | $9.33 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $173.78 Typical High $239.88 | Professional | 54 · Surgery only | $34.67 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $34.67 Typical High $47.86 | Professional | 55 · Aftercare only | $6.92 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $22.91 Typical High $32.36 | Professional | 56 · Pre-op care only | $4.68 | $22.91 | $32.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $831.76 Typical High $1,202.26 | Professional | 50 · Both sides | $354.81 | $831.76 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $275.42 Typical High $407.38 | Professional | 51 · Multiple procedures | $120.23 | $275.42 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $112.20 Typical High $162.18 | Professional | 80 · Assistant surgeon | $47.86 | $112.20 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $77.62 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $33.11 | $77.62 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $77.62 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $77.62 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $77.62 Typical High $112.20 | Professional | AS · PA/NP assist | $33.11 | $77.62 | $112.20 |
Where North Carolina sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 21st of 51
$275
IA $417NE $85.11
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.