How much rates vary
Facilitymedian $1,349 · 10th to 90th $339 to $5,129Professionalmedian $214 · 10th to 90th $115 to $437
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 $95.50 Median $144.54 Typical High $5,495.41 | Facility | None | $95.50 | $144.54 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $239.88 | Professional | None | $95.50 | $144.54 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $257.04 | Professional | None | $75.86 | $138.04 | $257.04 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,288.25 | $1,995.26 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $489.78 | Professional | None | $151.36 | $251.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,995.26 | Facility | None | $457.09 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $331.13 | Professional | None | $117.49 | $199.53 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $549.54 Typical High $1,819.70 | Facility | None | $169.82 | $549.54 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $323.59 | Professional | None | $141.25 | $218.78 | $323.59 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $316.23 | Professional | None | $97.72 | $165.96 | $316.23 |
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 $47.86 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $47.86 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $70.79 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $14.13 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $15.85 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $524.81 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $186.21 | $524.81 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $128.82 Typical High $213.80 | Professional | 51 · Multiple procedures | $69.18 | $128.82 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $51.29 Typical High $87.10 | Professional | 80 · Assistant surgeon | $28.18 | $51.29 | $87.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $36.31 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $19.50 | $36.31 | $60.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $36.31 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $36.31 | $60.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $36.31 Typical High $60.26 | Professional | AS · PA/NP assist | $19.50 | $36.31 | $60.26 |
Where North Carolina sits
The same service costs 12.7 times more in Colorado than in North Dakota. 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 $4,551ND $359
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.