How much rates vary
Facilitymedian $2,692 · 10th to 90th $603 to $8,318Professionalmedian $631 · 10th to 90th $347 to $955
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 $309.03 Median $1,288.25 Typical High $14,454.40 | Facility | None | $309.03 | $1,288.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $676.08 | Professional | None | $309.03 | $309.03 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $8,317.64 | Facility | None | $2,089.30 | $3,235.94 | $8,317.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,023.29 | Professional | None | $489.78 | $724.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $4,570.88 | Facility | None | $645.65 | $3,090.30 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $851.14 | Professional | None | $398.11 | $467.74 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $3,388.44 | Facility | None | $575.44 | $977.24 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $707.95 | Professional | None | $371.54 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $851.14 | Professional | None | $316.23 | $489.78 | $851.14 |
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 $154.88 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $34.67 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $831.76 Typical High $2,454.71 | Facility | 51 · Multiple procedures | $295.12 | $831.76 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $295.12 Typical High $457.09 | Professional | 51 · Multiple procedures | $208.93 | $295.12 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $117.49 Typical High $181.97 | Professional | 80 · Assistant surgeon | $83.18 | $117.49 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $83.18 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $57.54 | $83.18 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $83.18 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $83.18 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $83.18 Typical High $125.89 | Professional | AS · PA/NP assist | $57.54 | $83.18 | $125.89 |
Where North Carolina sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 16th of 51
$631
OK $2,884NY $288
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.