How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $2,455Professionalmedian $251 · 10th to 90th $126 to $372
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 $120.23 Median $870.96 Typical High $7,943.28 | Facility | None | $120.23 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,819.70 | Facility | None | $891.25 | $1,318.26 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $380.19 | Professional | None | $141.25 | $251.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,737.80 | Facility | None | $602.56 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $257.04 | Professional | None | $125.89 | $128.82 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $1,288.25 Typical High $1,737.80 | Facility | None | $194.98 | $1,288.25 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $165.96 | Professional | None | $114.82 | $158.49 | $165.96 |
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 $104.71 Median $134.90 Typical High $229.09 | Professional | None | $104.71 | $134.90 | $229.09 |
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 $60.26 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $436.52 Median $758.58 Typical High $870.96 | Facility | 51 · Multiple procedures | $436.52 | $758.58 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $83.18 Typical High $85.11 | Professional | 51 · Multiple procedures | $57.54 | $83.18 | $85.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $33.11 Typical High $33.11 | Professional | 80 · Assistant surgeon | $22.91 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $22.91 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $16.22 | $22.91 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $22.91 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $22.91 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $22.91 Typical High $22.91 | Professional | AS · PA/NP assist | $16.22 | $22.91 | $22.91 |
Where North Carolina sits
The same service costs 6.0 times more in Alaska 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· 7th of 51
$251
AK $501KY $83.18
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.