How much rates vary
Facilitymedian $891 · 10th to 90th $129 to $5,248Professionalmedian $251 · 10th to 90th $155 to $389
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 $128.82 Median $1,000.00 Typical High $7,943.28 | Facility | None | $128.82 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | None | $128.82 | $128.82 | $181.97 |
BCBS North Carolina Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $389.05 | Professional | None | $154.88 | $269.15 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $354.81 | Professional | None | $147.91 | $181.97 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $128.82 | Facility | None | $125.89 | $125.89 | $128.82 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $288.40 | Professional | None | $162.18 | $190.55 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $125.89 Median $169.82 Typical High $354.81 | Professional | None | $125.89 | $169.82 | $354.81 |
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 $63.10 Median $64.57 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $95.50 Typical High $190.55 | Professional | 51 · Multiple procedures | $83.18 | $95.50 | $190.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $38.02 Typical High $75.86 | Professional | 80 · Assistant surgeon | $33.11 | $38.02 | $75.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $26.92 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $23.44 | $26.92 | $53.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $26.92 Typical High $53.70 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $26.92 | $53.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $26.92 Typical High $53.70 | Professional | AS · PA/NP assist | $23.44 | $26.92 | $53.70 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska 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· 8th of 51
$257
AK $447NY $120
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.