How much rates vary
Facilitymedian $724 · 10th to 90th $282 to $6,761Professionalmedian $178 · 10th to 90th $115 to $288
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 $104.71 Median $104.71 Typical High $7,943.28 | Facility | None | $104.71 | $104.71 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | None | $104.71 | $104.71 | $125.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $309.03 | Professional | None | $114.82 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $213.80 | Professional | None | $117.49 | $120.23 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $724.44 Typical High $724.44 | Facility | None | $125.89 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $169.82 | Professional | None | $100.00 | $138.04 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
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 $93.33 Median $114.82 Typical High $199.53 | Professional | None | $93.33 | $114.82 | $199.53 |
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 $52.48 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $52.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 54 · Surgery only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $69.18 Typical High $93.33 | Professional | 51 · Multiple procedures | $50.12 | $69.18 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $27.54 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.95 | $27.54 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $19.50 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $13.80 | $19.50 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $19.50 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $19.50 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $19.50 Typical High $25.70 | Professional | AS · PA/NP assist | $13.80 | $19.50 | $25.70 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 12th of 51
$178
AK $427NJ $97.72
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.