How much rates vary
Facilitymedian $380 · 10th to 90th $79 to $912Professionalmedian $60 · 10th to 90th $35 to $115
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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None (both parts) | $46.77 | $46.77 | $54.95 |
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 $34.67 Median $58.88 Typical High $123.03 | Professional | None (both parts) | $34.67 | $58.88 | $123.03 |
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 $60.26 Median $74.13 Typical High $128.82 | Professional | None (both parts) | $60.26 | $74.13 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $363.08 Typical High $758.58 | Facility | None | $46.77 | $363.08 | $758.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $51.29 Median $69.18 Typical High $77.62 | Professional | None (both parts) | $51.29 | $69.18 | $77.62 |
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 $47.86 Median $67.61 Typical High $114.82 | Professional | None (both parts) | $47.86 | $67.61 | $114.82 |
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 $23.44 Median $23.44 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.13 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $28.18 Typical High $31.62 | Professional | 26 · Professional part | $23.44 | $28.18 | $31.62 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $104.71 Typical High $208.93 | Professional | 50 · Both sides | $93.33 | $104.71 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $35.48 Typical High $69.18 | Professional | 51 · Multiple procedures | $30.90 | $35.48 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $14.13 Typical High $27.54 | Professional | 80 · Assistant surgeon | $12.30 | $14.13 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.71 Median $9.77 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $8.71 | $9.77 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.71 Median $9.77 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $8.71 | $9.77 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.71 Median $9.77 Typical High $19.50 | Professional | AS · PA/NP assist | $8.71 | $9.77 | $19.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $41.69 Typical High $46.77 | Professional | TC · Technical part | $34.67 | $41.69 | $46.77 |
Where North Carolina sits
The same service costs 4.7 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· 39th of 51
$60.26
WI $200KY $42.66
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.