How much rates vary
Facilitymedian $1,096 · 10th to 90th $479 to $3,388Professionalmedian $339 · 10th to 90th $214 to $562
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 $177.83 Median $1,148.15 Typical High $7,943.28 | Facility | None | $177.83 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | None | $177.83 | $177.83 | $213.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,388.44 | Facility | None | $851.14 | $1,318.26 | $3,388.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $588.84 | Professional | None | $229.09 | $380.19 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $1,819.70 | Facility | None | $602.56 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $389.05 | Professional | None | $213.80 | $213.80 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | None | $316.23 | $316.23 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $724.44 Typical High $1,258.93 | Facility | None | $346.74 | $724.44 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $380.19 | Professional | None | $169.82 | $251.19 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | None | $257.04 | $257.04 | $269.15 |
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 $162.18 Median $208.93 Typical High $346.74 | Professional | None | $162.18 | $208.93 | $346.74 |
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 $89.13 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $89.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $20.89 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $398.11 Typical High $851.14 | Facility | 51 · Multiple procedures | $263.03 | $398.11 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $128.82 Typical High $213.80 | Professional | 51 · Multiple procedures | $85.11 | $128.82 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $51.29 Typical High $75.86 | Professional | 80 · Assistant surgeon | $33.88 | $51.29 | $75.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $35.48 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $23.99 | $35.48 | $53.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $35.48 Typical High $53.70 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $35.48 | $53.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $35.48 Typical High $53.70 | Professional | AS · PA/NP assist | $23.99 | $35.48 | $53.70 |
Where North Carolina sits
The same service costs 7.3 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 $4,136MT $564
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.