How much rates vary
Facilitymedian $234 · 10th to 90th $100 to $741Professionalmedian $380 · 10th to 90th $209 to $603
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 $194.98 Median $194.98 Typical High $7,943.28 | Facility | None | $194.98 | $194.98 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $323.59 | Professional | None | $194.98 | $194.98 | $323.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $371.54 | Facility | None | $186.21 | $275.42 | $371.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $630.96 | Professional | None | $257.04 | $416.87 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $251.19 Typical High $407.38 | Facility | None | $56.23 | $251.19 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $380.19 | Facility | None | $144.54 | $223.87 | $380.19 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $371.54 | Professional | None | $234.42 | $257.04 | $371.54 |
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 $190.55 Median $281.84 Typical High $478.63 | Professional | None | $190.55 | $281.84 | $478.63 |
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 $97.72 Median $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $22.91 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $112.20 Typical High $186.21 | Facility | 51 · Multiple procedures | $72.44 | $112.20 | $186.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $128.82 Typical High $288.40 | Professional | 51 · Multiple procedures | $125.89 | $128.82 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $51.29 Typical High $114.82 | Professional | 80 · Assistant surgeon | $50.12 | $51.29 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $35.48 Typical High $79.43 | Professional | 81 · Minimal assistant surgeon | $34.67 | $35.48 | $79.43 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $35.48 Typical High $79.43 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $35.48 | $79.43 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $35.48 Typical High $79.43 | Professional | AS · PA/NP assist | $34.67 | $35.48 | $79.43 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 13th of 51
$339
AK $631UT $195
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.