How much rates vary
Facilitymedian $776 · 10th to 90th $380 to $4,898Professionalmedian $832 · 10th to 90th $490 to $1,259
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 $467.74 Median $467.74 Typical High $7,943.28 | Facility | None | $467.74 | $467.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $758.58 | Professional | None | $457.09 | $467.74 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $1,288.25 | Professional | None | $602.56 | $912.01 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,000.00 | Professional | None | $549.54 | $660.69 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $1,995.26 | Facility | None | $467.74 | $562.34 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $851.14 | Professional | None | $562.34 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,148.15 | Professional | None | $467.74 | $660.69 | $1,148.15 |
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 $234.42 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $54.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $309.03 Typical High $691.83 | Professional | 51 · Multiple procedures | $295.12 | $309.03 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $123.03 Typical High $275.42 | Professional | 80 · Assistant surgeon | $117.49 | $123.03 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $85.11 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $83.18 | $85.11 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $85.11 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $85.11 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $85.11 Typical High $190.55 | Professional | AS · PA/NP assist | $83.18 | $85.11 | $190.55 |
Where North Carolina sits
The same service costs 3.4 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· 10th of 51
$832
AK $1,514UT $447
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.