How much rates vary
Facilitymedian $309 · 10th to 90th $89 to $933Professionalmedian $87 · 10th to 90th $46 to $162
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 $50.12 Median $1,000.00 Typical High $7,943.28 | Facility | None | $50.12 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | None | $50.12 | $50.12 | $70.79 |
BCBS North Carolina Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $741.31 | Facility | None | $186.21 | $288.40 | $741.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $162.18 | Professional | None | $45.71 | $100.00 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $707.95 | Facility | None | $288.40 | $416.87 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $107.15 | Professional | None | $61.66 | $61.66 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | None | $93.33 | $93.33 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $251.19 Typical High $363.08 | Facility | None | $100.00 | $251.19 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $100.00 | Professional | None | $47.86 | $66.07 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | None | $69.18 | $69.18 | $72.44 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $97.72 | Professional | None | $46.77 | $58.88 | $97.72 |
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 $25.12 Median $25.12 Typical High $30.90 | Professional | 52 · Reduced service | $25.12 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $12.30 | Professional | 53 · Discontinued | $10.00 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 54 · Surgery only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $9.33 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $6.17 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $79.43 Median $125.89 Typical High $263.03 | Facility | 51 · Multiple procedures | $79.43 | $125.89 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $35.48 Typical High $57.54 | Professional | 51 · Multiple procedures | $23.99 | $35.48 | $57.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $14.13 Typical High $20.42 | Professional | 80 · Assistant surgeon | $9.55 | $14.13 | $20.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.61 Median $10.00 Typical High $14.13 | Professional | 81 · Minimal assistant surgeon | $6.61 | $10.00 | $14.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.61 Median $10.00 Typical High $14.13 | Professional | 82 · Assistant surgeon, no resident | $6.61 | $10.00 | $14.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.61 Median $10.00 Typical High $14.13 | Professional | AS · PA/NP assist | $6.61 | $10.00 | $14.13 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 13th of 51
$87.10
AK $200FL $47.86
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.