How much rates vary
Facilitymedian $1,349 · 10th to 90th $427 to $5,012Professionalmedian $251 · 10th to 90th $148 to $407
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 $173.78 Median $1,445.44 Typical High $10,715.19 | Facility | None | $173.78 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | None | $181.97 | $181.97 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,949.84 | $3,019.95 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $436.52 | Professional | None | $158.49 | $251.19 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $1,905.46 Typical High $2,754.23 | Facility | None | $281.84 | $1,905.46 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $338.84 | Professional | None | $144.54 | $162.18 | $338.84 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $436.52 | Professional | None | $134.90 | $186.21 | $436.52 |
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 $87.10 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.05 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $524.81 Median $1,023.29 Typical High $1,380.38 | Facility | 51 · Multiple procedures | $524.81 | $1,023.29 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $81.28 Typical High $251.19 | Professional | 51 · Multiple procedures | $72.44 | $81.28 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $32.36 Typical High $100.00 | Professional | 80 · Assistant surgeon | $28.84 | $32.36 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $22.91 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $19.95 | $22.91 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $22.91 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $22.91 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $22.91 Typical High $69.18 | Professional | AS · PA/NP assist | $19.95 | $22.91 | $69.18 |
Where North Carolina sits
The same service costs 11.9 times more in Oklahoma 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
OK $6,102MT $514
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.