How much rates vary
Facilitymedian $288 · 10th to 90th $120 to $871Professionalmedian $229 · 10th to 90th $145 to $417
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 $169.82 Median $1,000.00 Typical High $7,943.28 | Facility | None | $169.82 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $239.88 | Professional | None | $169.82 | $169.82 | $239.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $363.08 | Facility | None | $186.21 | $269.15 | $363.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $467.74 | Professional | None | $169.82 | $229.09 | $467.74 |
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 $134.90 Median $138.04 Typical High $338.84 | Professional | None | $134.90 | $138.04 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $389.05 | Professional | None | $204.17 | $204.17 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $501.19 | Facility | None | $158.49 | $251.19 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $218.78 | Professional | None | $144.54 | $151.36 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
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 $107.15 Median $173.78 Typical High $302.00 | Professional | None | $107.15 | $173.78 | $302.00 |
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 $85.11 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $33.88 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $20.89 |
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 $72.44 Median $75.86 Typical High $125.89 | Professional | 51 · Multiple procedures | $72.44 | $75.86 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $30.20 Typical High $47.86 | Professional | 80 · Assistant surgeon | $29.51 | $30.20 | $47.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $21.38 Typical High $33.11 | Professional | 81 · Minimal assistant surgeon | $20.42 | $21.38 | $33.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $21.38 Typical High $33.11 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $21.38 | $33.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $21.38 Typical High $33.11 | Professional | AS · PA/NP assist | $20.42 | $21.38 | $33.11 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska than in Utah. 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
$229
AK $603UT $132
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.