How much rates vary
Facilitymedian $166 · 10th to 90th $79 to $794Professionalmedian $95 · 10th to 90th $36 to $288
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 $27.54 Median $95.50 Typical High $7,413.10 | Facility | None | $27.54 | $95.50 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $95.50 Typical High $125.89 | Professional | None | $27.54 | $95.50 | $125.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $269.15 | Facility | None | $131.83 | $199.53 | $269.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $316.23 | Professional | None | $47.86 | $100.00 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $144.54 Typical High $218.78 | Facility | None | $56.23 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $91.20 Typical High $213.80 | Professional | None | $36.31 | $91.20 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $165.96 Typical High $724.44 | Facility | None | $95.50 | $165.96 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $162.18 | Professional | None | $60.26 | $123.03 | $162.18 |
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 Typical Low $30.20 Median $87.10 Typical High $213.80 | Professional | None | $30.20 | $87.10 | $213.80 |
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 $13.49 Median $25.12 Typical High $51.29 | Professional | 52 · Reduced service | $13.49 | $25.12 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $10.00 Typical High $20.42 | Professional | 53 · Discontinued | $5.50 | $10.00 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $37.15 Typical High $77.62 | Professional | 54 · Surgery only | $20.42 | $37.15 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $7.59 Typical High $15.49 | Professional | 55 · Aftercare only | $4.07 | $7.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $5.01 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.75 | $5.01 | $10.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $63.10 Median $123.03 Typical High $363.08 | Facility | 51 · Multiple procedures | $63.10 | $123.03 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $61.66 Typical High $138.04 | Professional | 51 · Multiple procedures | $30.20 | $61.66 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $24.55 Typical High $54.95 | Professional | 80 · Assistant surgeon | $12.02 | $24.55 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.32 Median $16.98 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $8.32 | $16.98 | $38.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.32 Median $16.98 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $8.32 | $16.98 | $38.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $16.98 Typical High $38.02 | Professional | AS · PA/NP assist | $8.32 | $16.98 | $38.02 |
Where North Carolina sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 36th of 51
$95.50
WI $209HI $38.90
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.