How much rates vary
Facilitymedian $1,698 · 10th to 90th $417 to $4,898Professionalmedian $174 · 10th to 90th $102 to $269
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 $100.00 Median $100.00 Typical High $151.36 | Facility | None | $100.00 | $100.00 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $162.18 | Professional | None | $95.50 | $100.00 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $204.17 | Professional | None | $141.25 | $141.25 | $204.17 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,659.59 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $275.42 | Professional | None | $128.82 | $194.98 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $2,454.71 Typical High $4,168.69 | Facility | None | $416.87 | $2,454.71 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $213.80 | Professional | None | $117.49 | $141.25 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $1,380.38 Typical High $2,398.83 | Facility | None | $194.98 | $1,380.38 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $229.09 | Professional | None | $120.23 | $128.82 | $229.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $245.47 | Professional | None | $97.72 | $144.54 | $245.47 |
10 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 $50.12 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $11.48 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $446.68 Median $691.83 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $446.68 | $691.83 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $64.57 Typical High $144.54 | Professional | 51 · Multiple procedures | $63.10 | $64.57 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.70 Typical High $58.88 | Professional | 80 · Assistant surgeon | $25.12 | $25.70 | $58.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $18.20 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $17.78 | $18.20 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $18.20 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $18.20 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $18.20 Typical High $40.74 | Professional | AS · PA/NP assist | $17.78 | $18.20 | $40.74 |
Where North Carolina sits
The same service costs 7.9 times more in Kansas 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· 20th of 51
$174
KS $832NY $105
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.