How much rates vary
Facilitymedian $692 · 10th to 90th $69 to $2,951Professionalmedian $295 · 10th to 90th $107 to $537
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 $69.18 Median $165.96 Typical High $5,495.41 | Facility | None | $69.18 | $165.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $165.96 Typical High $234.42 | Professional | None | $69.18 | $165.96 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $575.44 | Professional | None | $131.83 | $295.12 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $363.08 | Professional | None | $91.20 | $208.93 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $190.55 | Facility | None | $69.18 | $69.18 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $302.00 | Professional | None | $218.78 | $288.40 | $302.00 |
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 $72.44 Median $181.97 Typical High $389.05 | Professional | None | $72.44 | $181.97 | $389.05 |
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 $33.88 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $33.88 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $33.11 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $51.29 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $10.23 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.60 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.92 | $16.60 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $144.54 Typical High $251.19 | Professional | 51 · Multiple procedures | $144.54 | $144.54 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | 80 · Assistant surgeon | $57.54 | $57.54 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $40.74 Median $40.74 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $40.74 | $40.74 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $40.74 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $40.74 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $40.74 Typical High $69.18 | Professional | AS · PA/NP assist | $40.74 | $40.74 | $69.18 |
Where North Carolina sits
The same service costs 2.7 times more in Wisconsin 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· 2nd of 51
$295
WI $316UT $117
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.