How much rates vary
Facilitymedian $724 · 10th to 90th $295 to $4,677Professionalmedian $457 · 10th to 90th $275 to $646
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 $239.88 Median $239.88 Typical High $7,943.28 | Facility | None | $239.88 | $239.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | None | $239.88 | $239.88 | $281.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $691.83 | Professional | None | $295.12 | $457.09 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $478.63 | Professional | None | $269.15 | $281.84 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $562.34 | Professional | None | $436.52 | $436.52 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $724.44 Typical High $724.44 | Facility | None | $288.40 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $309.03 | Professional | None | $223.87 | $302.00 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | None | $275.42 | $275.42 | $288.40 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $457.09 | Professional | None | $213.80 | $263.03 | $457.09 |
10 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 $120.23 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $27.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $154.88 Typical High $173.78 | Professional | 51 · Multiple procedures | $112.20 | $154.88 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $61.66 Typical High $64.57 | Professional | 80 · Assistant surgeon | $44.67 | $61.66 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $42.66 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $31.62 | $42.66 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $42.66 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $42.66 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $42.66 Typical High $45.71 | Professional | AS · PA/NP assist | $31.62 | $42.66 | $45.71 |
Where North Carolina sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 8th of 51
$457
AK $977UT $195
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.