How much rates vary
Facilitymedian $1,072 · 10th to 90th $479 to $3,311Professionalmedian $525 · 10th to 90th $331 to $891
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 $275.42 Median $1,148.15 Typical High $7,943.28 | Facility | None | $275.42 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $354.81 | Professional | None | $275.42 | $275.42 | $354.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $562.34 Median $870.96 Typical High $2,238.72 | Facility | None | $562.34 | $870.96 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $891.25 | Professional | None | $407.38 | $588.84 | $891.25 |
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 $331.13 Median $338.84 Typical High $575.44 | Professional | None | $331.13 | $338.84 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $645.65 | Professional | None | $501.19 | $501.19 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $1,258.93 | Facility | None | $446.68 | $645.65 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $524.81 | Professional | None | $263.03 | $371.54 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | None | $371.54 | $371.54 | $389.05 |
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 $257.04 Median $323.59 Typical High $549.54 | Professional | None | $257.04 | $323.59 | $549.54 |
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 $138.04 Median $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $32.36 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $229.09 Median $331.13 Typical High $851.14 | Facility | 51 · Multiple procedures | $229.09 | $331.13 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $194.98 Typical High $275.42 | Professional | 51 · Multiple procedures | $131.83 | $194.98 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $79.43 Typical High $112.20 | Professional | 80 · Assistant surgeon | $52.48 | $79.43 | $112.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $54.95 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $37.15 | $54.95 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $54.95 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $54.95 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $54.95 Typical High $77.62 | Professional | AS · PA/NP assist | $37.15 | $54.95 | $77.62 |
Where North Carolina sits
The same service costs 5.2 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 $4,508MT $873
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.