How much rates vary
Facilitymedian $891 · 10th to 90th $162 to $3,548Professionalmedian $219 · 10th to 90th $95 to $447
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 $74.13 Median $169.82 Typical High $2,630.27 | Facility | None | $74.13 | $169.82 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $169.82 Typical High $239.88 | Professional | None | $74.13 | $169.82 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $295.12 | Professional | None | $60.26 | $100.00 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $645.65 | Facility | None | $162.18 | $245.47 | $645.65 |
BCBS North Carolina Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $478.63 | Professional | None | $125.89 | $302.00 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,951.21 | Facility | None | $602.56 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $363.08 | Professional | None | $97.72 | $208.93 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $1,071.52 Typical High $1,778.28 | Facility | None | $89.13 | $1,071.52 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $281.84 | Professional | None | $165.96 | $229.09 | $281.84 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $338.84 | Professional | None | $77.62 | $169.82 | $338.84 |
11 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 $37.15 Median $81.28 Typical High $87.10 | Professional | 52 · Reduced service | $37.15 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $33.11 Typical High $34.67 | Professional | 53 · Discontinued | $14.79 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $123.03 Typical High $128.82 | Professional | 54 · Surgery only | $56.23 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $24.55 Typical High $25.70 | Professional | 55 · Aftercare only | $11.22 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.41 | $16.22 | $17.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $346.74 Typical High $724.44 | Professional | 50 · Both sides | $323.59 | $346.74 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $114.82 Typical High $239.88 | Professional | 51 · Multiple procedures | $107.15 | $114.82 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $45.71 Typical High $95.50 | Professional | 80 · Assistant surgeon | $42.66 | $45.71 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $32.36 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $30.20 | $32.36 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $32.36 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $32.36 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $32.36 Typical High $67.61 | Professional | AS · PA/NP assist | $30.20 | $32.36 | $67.61 |
Where North Carolina sits
The same service costs 9.7 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,351MT $447
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.