How much rates vary
Facilitymedian $1,995 · 10th to 90th $832 to $6,310Professionalmedian $209 · 10th to 90th $138 to $380
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 $128.82 Median $1,288.25 Typical High $10,715.19 | Facility | None | $128.82 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,187.76 | Facility | None | $1,122.02 | $1,659.59 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $398.11 | Professional | None | $177.83 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,467.37 | Facility | None | $912.01 | $2,818.38 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $275.42 | Professional | None | $151.36 | $186.21 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $977.24 Typical High $2,398.83 | Facility | None | $295.12 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | None | $123.03 | $169.82 | $213.80 |
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 $128.82 Median $186.21 Typical High $316.23 | Professional | None | $128.82 | $186.21 | $316.23 |
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 $64.57 Median $64.57 Typical High $74.13 | Professional | 52 · Reduced service | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $14.79 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $512.86 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $416.87 | $512.86 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $100.00 Typical High $186.21 | Professional | 51 · Multiple procedures | $61.66 | $100.00 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $39.81 Typical High $74.13 | Professional | 80 · Assistant surgeon | $24.55 | $39.81 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $27.54 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $17.38 | $27.54 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $27.54 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $27.54 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $27.54 Typical High $52.48 | Professional | AS · PA/NP assist | $17.38 | $27.54 | $52.48 |
Where North Carolina sits
The same service costs 10.7 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· 21st of 51
$224
OK $1,413NY $132
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.