How much rates vary
Facilitymedian $372 · 10th to 90th $79 to $955Professionalmedian $91 · 10th to 90th $52 to $174
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 $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | None (both parts) | $69.18 | $69.18 | $83.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $645.65 | Facility | None | $323.59 | $478.63 | $645.65 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $52.48 Median $89.13 Typical High $186.21 | Professional | None (both parts) | $52.48 | $89.13 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $1,000.00 | Facility | None | $346.74 | $457.09 | $1,000.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $100.00 Typical High $194.98 | Professional | None (both parts) | $74.13 | $100.00 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $363.08 Typical High $758.58 | Facility | None | $70.79 | $363.08 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $77.62 Median $104.71 Typical High $120.23 | Professional | None (both parts) | $77.62 | $104.71 | $120.23 |
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 (both parts) Typical Low $72.44 Median $102.33 Typical High $173.78 | Professional | None (both parts) | $72.44 | $102.33 | $173.78 |
12 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 $34.67 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $34.67 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $16.60 | Professional | 53 · Discontinued | $14.13 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $8.32 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $42.66 Typical High $47.86 | Professional | 26 · Professional part | $34.67 | $42.66 | $47.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $158.49 Typical High $309.03 | Professional | 50 · Both sides | $141.25 | $158.49 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $52.48 Typical High $104.71 | Professional | 51 · Multiple procedures | $46.77 | $52.48 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $20.89 Typical High $41.69 | Professional | 80 · Assistant surgeon | $18.62 | $20.89 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $14.79 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $13.18 | $14.79 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $14.79 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $14.79 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $14.79 Typical High $28.84 | Professional | AS · PA/NP assist | $13.18 | $14.79 | $28.84 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $63.10 Typical High $72.44 | Professional | TC · Technical part | $52.48 | $63.10 | $72.44 |
Where North Carolina sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 33rd of 51
$102
WI $288KY $64.57
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.