How much rates vary
Facilitymedian $89 · 10th to 90th $56 to $708Professionalmedian $132 · 10th to 90th $71 to $209
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 $57.54 Median $89.13 Typical High $5,248.07 | Facility | None | $57.54 | $89.13 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $109.65 | Professional | None | $57.54 | $89.13 | $109.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $85.11 | Facility | None | $41.69 | $63.10 | $85.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $245.47 | Professional | None | $87.10 | $151.36 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $93.33 Typical High $524.81 | Facility | None | $60.26 | $93.33 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $181.97 | Professional | None | $70.79 | $104.71 | $181.97 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $75.86 Typical High $120.23 | Facility | None | $52.48 | $75.86 | $120.23 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $147.91 | Professional | None | $89.13 | $109.65 | $147.91 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $190.55 | Professional | None | $58.88 | $93.33 | $190.55 |
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 $28.18 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $28.18 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $11.48 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $54.95 Typical High $67.61 | Professional | 54 · Surgery only | $42.66 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $8.51 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.75 | $7.41 | $8.91 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $23.99 Median $38.02 Typical High $60.26 | Facility | 51 · Multiple procedures | $23.99 | $38.02 | $60.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $61.66 Typical High $125.89 | Professional | 51 · Multiple procedures | $52.48 | $61.66 | $125.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.89 Median $24.55 Typical High $50.12 | Professional | 80 · Assistant surgeon | $20.89 | $24.55 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.79 Median $16.98 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $14.79 | $16.98 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.79 Median $16.98 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $14.79 | $16.98 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $16.98 Typical High $34.67 | Professional | AS · PA/NP assist | $14.79 | $16.98 | $34.67 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 9th of 51
$126
WI $240DC $77.62
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.