How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $3,388Professionalmedian $676 · 10th to 90th $437 to $1,202
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 $380.19 Median $1,148.15 Typical High $7,943.28 | Facility | None | $380.19 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $3,388.44 | Facility | None | $851.14 | $1,348.96 | $3,388.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,230.27 | Professional | None | $467.74 | $794.33 | $1,230.27 |
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 $446.68 Median $457.09 Typical High $776.25 | Professional | None | $446.68 | $457.09 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $1,621.81 | Facility | None | $512.86 | $724.44 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $616.60 | Professional | None | $354.81 | $524.81 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | None | $489.78 | $489.78 | $512.86 |
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 $346.74 Median $436.52 Typical High $741.31 | Professional | None | $346.74 | $436.52 | $741.31 |
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 $186.21 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $44.67 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $398.11 Typical High $851.14 | Facility | 51 · Multiple procedures | $257.04 | $398.11 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $269.15 Typical High $363.08 | Professional | 51 · Multiple procedures | $177.83 | $269.15 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $72.44 | $107.15 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $75.86 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $50.12 | $75.86 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $75.86 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $75.86 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $75.86 Typical High $100.00 | Professional | AS · PA/NP assist | $50.12 | $75.86 | $100.00 |
Where North Carolina sits
The same service costs 3.8 times more in Colorado than in Delaware. 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 $4,403DE $1,156
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.