How much rates vary
Facilitymedian $2,630 · 10th to 90th $69 to $7,244Professionalmedian $186 · 10th to 90th $87 to $275
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 $69.18 Median $107.15 Typical High $7,413.10 | Facility | None | $69.18 | $107.15 | $7,413.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $107.15 Typical High $131.83 | Professional | None (both parts) | $69.18 | $107.15 | $131.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $112.20 Median $186.21 Typical High $275.42 | Professional | None (both parts) | $112.20 | $186.21 | $275.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $147.91 Typical High $245.47 | Professional | None (both parts) | $79.43 | $147.91 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $128.82 | Facility | None | $69.18 | $70.79 | $128.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $151.36 Median $154.88 Typical High $162.18 | Professional | None (both parts) | $151.36 | $154.88 | $162.18 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $4,365.16 Typical High $7,244.36 | Facility | None | $1,995.26 | $4,365.16 | $7,244.36 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $123.03 Typical High $263.03 | Professional | None (both parts) | $75.86 | $123.03 | $263.03 |
12 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 $34.67 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $34.67 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $14.13 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $10.47 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.92 | $10.72 | $12.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $61.66 Typical High $64.57 | Professional | 26 · Professional part | $60.26 | $61.66 | $64.57 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | 50 · Both sides | $229.09 | $229.09 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 51 · Multiple procedures | $77.62 | $77.62 | $109.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $30.90 Typical High $42.66 | Professional | 80 · Assistant surgeon | $30.90 | $30.90 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $21.38 | $21.38 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $21.38 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $21.38 Typical High $30.20 | Professional | AS · PA/NP assist | $21.38 | $21.38 | $30.20 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $93.33 Typical High $95.50 | Professional | TC · Technical part | $91.20 | $93.33 | $95.50 |
Where North Carolina sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 14th of 51
$186
OK $832MI $95.50
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.