How much rates vary
Facilitymedian $282 · 10th to 90th $110 to $1,096Professionalmedian $355 · 10th to 90th $240 to $661
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 $208.93 Median $257.04 Typical High $7,413.10 | Facility | None | $208.93 | $257.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $281.84 | Professional | None | $208.93 | $251.19 | $281.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $190.55 Median $295.12 Typical High $758.58 | Facility | None | $190.55 | $295.12 | $758.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $707.95 | Professional | None | $239.88 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $1,318.26 | Facility | None | $199.53 | $323.59 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $616.60 | Professional | None | $257.04 | $309.03 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $371.54 Typical High $524.81 | Facility | None | $154.88 | $371.54 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $426.58 | Professional | None | $302.00 | $316.23 | $426.58 |
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 $213.80 Median $316.23 Typical High $588.84 | Professional | None | $213.80 | $316.23 | $588.84 |
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 $104.71 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $41.69 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $26.30 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $186.21 Typical High $263.03 | Facility | 51 · Multiple procedures | $72.44 | $186.21 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $154.88 Typical High $363.08 | Professional | 51 · Multiple procedures | $151.36 | $154.88 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $63.10 Typical High $144.54 | Professional | 80 · Assistant surgeon | $60.26 | $63.10 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $43.65 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $42.66 | $43.65 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $43.65 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $43.65 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $43.65 Typical High $100.00 | Professional | AS · PA/NP assist | $42.66 | $43.65 | $100.00 |
Where North Carolina sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 17th of 51
$347
AK $851MD $229
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.