How much rates vary
Facilitymedian $776 · 10th to 90th $282 to $4,898Professionalmedian $309 · 10th to 90th $214 to $513
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 $199.53 Median $199.53 Typical High $7,943.28 | Facility | None | $199.53 | $199.53 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | None | $199.53 | $199.53 | $239.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $512.86 | Professional | None | $257.04 | $354.81 | $512.86 |
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 $229.09 Median $234.42 Typical High $549.54 | Professional | None | $229.09 | $234.42 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $478.63 | Professional | None | $371.54 | $371.54 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $831.76 | Facility | None | $199.53 | $239.88 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $363.08 | Professional | None | $245.47 | $251.19 | $363.08 |
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 $173.78 Median $245.47 Typical High $489.78 | Professional | None | $173.78 | $245.47 | $489.78 |
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 $100.00 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $125.89 Typical High $234.42 | Professional | 51 · Multiple procedures | $123.03 | $125.89 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $50.12 Typical High $93.33 | Professional | 80 · Assistant surgeon | $48.98 | $50.12 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $34.67 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $34.67 | $34.67 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $34.67 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $34.67 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $34.67 Typical High $66.07 | Professional | AS · PA/NP assist | $34.67 | $34.67 | $66.07 |
Where North Carolina sits
The same service costs 5.1 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· 21st of 51
$309
AK $832UT $162
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.