How much rates vary
Facilitymedian $741 · 10th to 90th $37 to $2,951Professionalmedian $200 · 10th to 90th $58 to $427
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 $37.15 Median $181.97 Typical High $7,413.10 | Facility | None | $37.15 | $181.97 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $138.04 Typical High $245.47 | Professional | None | $37.15 | $138.04 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $91.20 | Professional | None | $48.98 | $48.98 | $91.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $199.53 Typical High $426.58 | Professional | None | $70.79 | $199.53 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $131.83 Typical High $354.81 | Professional | None | $45.71 | $131.83 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $190.55 | Facility | None | $37.15 | $37.15 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $186.21 Typical High $338.84 | Professional | None | $69.18 | $186.21 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $309.03 | Professional | None | $38.90 | $138.04 | $309.03 |
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 $18.62 Median $61.66 Typical High $91.20 | Professional | 52 · Reduced service | $18.62 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $24.55 Typical High $36.31 | Professional | 53 · Discontinued | $7.41 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $91.20 Typical High $138.04 | Professional | 54 · Surgery only | $27.54 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $18.62 Typical High $27.54 | Professional | 55 · Aftercare only | $5.50 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $12.30 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.72 | $12.30 | $18.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $93.33 Typical High $234.42 | Professional | 51 · Multiple procedures | $34.67 | $93.33 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.80 Median $38.02 Typical High $93.33 | Professional | 80 · Assistant surgeon | $13.80 | $38.02 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $26.30 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $9.55 | $26.30 | $64.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $26.30 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $26.30 | $64.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $26.30 Typical High $64.57 | Professional | AS · PA/NP assist | $9.55 | $26.30 | $64.57 |
Where North Carolina sits
The same service costs 4.5 times more in Wisconsin 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· 7th of 51
$200
WI $251MI $56.23
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.