How much rates vary
Facilitymedian $380 · 10th to 90th $79 to $912Professionalmedian $13 · 10th to 90th $9 to $39
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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None (both parts) Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | None (both parts) | $11.75 | $11.75 | $13.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $676.08 | Facility | None | $331.13 | $478.63 | $676.08 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $8.91 Median $11.22 Typical High $36.31 | Professional | None (both parts) | $8.91 | $11.22 | $36.31 |
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 $15.14 Median $23.99 Typical High $74.13 | Professional | None (both parts) | $15.14 | $23.99 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $363.08 Typical High $758.58 | Facility | None | $11.75 | $363.08 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.88 Median $17.38 Typical High $20.42 | Professional | None (both parts) | $12.88 | $17.38 | $20.42 |
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 $12.02 Median $17.38 Typical High $28.84 | Professional | None (both parts) | $12.02 | $17.38 | $28.84 |
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 $5.89 Median $5.89 Typical High $6.92 | Professional | 52 · Reduced service | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.75 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5.89 Median $7.08 Typical High $8.13 | Professional | 26 · Professional part | $5.89 | $7.08 | $8.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $23.99 Median $26.30 Typical High $52.48 | Professional | 50 · Both sides | $23.99 | $26.30 | $52.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.13 Median $8.91 Typical High $17.38 | Professional | 51 · Multiple procedures | $8.13 | $8.91 | $17.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.24 Median $3.55 Typical High $7.08 | Professional | 80 · Assistant surgeon | $3.24 | $3.55 | $7.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.24 Median $2.45 Typical High $4.90 | Professional | 81 · Minimal assistant surgeon | $2.24 | $2.45 | $4.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.24 Median $2.45 Typical High $4.90 | Professional | 82 · Assistant surgeon, no resident | $2.24 | $2.45 | $4.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.24 Median $2.45 Typical High $4.90 | Professional | AS · PA/NP assist | $2.24 | $2.45 | $4.90 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $8.71 Median $10.72 Typical High $12.02 | Professional | TC · Technical part | $8.71 | $10.72 | $12.02 |
Where North Carolina sits
The same service costs 12.3 times more in Florida 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· 43rd of 51
$15.14
FL $132KY $10.72
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.