How much rates vary
Facilitymedian $95 · 10th to 90th $59 to $851Professionalmedian $138 · 10th to 90th $69 to $257
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 $43.65 Median $79.43 Typical High $7,413.10 | Facility | None | $43.65 | $79.43 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $154.88 | Professional | None | $43.65 | $79.43 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $102.33 | Facility | None | $51.29 | $77.62 | $102.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $257.04 | Professional | None | $93.33 | $151.36 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $524.81 | Facility | None | $61.66 | $95.50 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $204.17 | Professional | None | $81.28 | $131.83 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $81.28 Typical High $177.83 | Facility | None | $52.48 | $81.28 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $190.55 | Professional | None | $81.28 | $147.91 | $190.55 |
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 $42.66 Median $93.33 Typical High $177.83 | Professional | None | $42.66 | $93.33 | $177.83 |
13 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 $21.88 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $21.88 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $60.26 Typical High $63.10 | Professional | 54 · Surgery only | $33.11 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $6.61 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $7.94 | $8.51 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $79.43 Median $123.03 Typical High $263.03 | Facility | 50 · Both sides | $79.43 | $123.03 | $263.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $26.30 Median $40.74 Typical High $89.13 | Facility | 51 · Multiple procedures | $26.30 | $40.74 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $223.87 Typical High $302.00 | Professional | 50 · Both sides | $186.21 | $223.87 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $74.13 Typical High $100.00 | Professional | 51 · Multiple procedures | $63.10 | $74.13 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $29.51 Typical High $39.81 | Professional | 80 · Assistant surgeon | $25.12 | $29.51 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $20.89 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $17.38 | $20.89 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $20.89 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $20.89 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $20.89 Typical High $28.18 | Professional | AS · PA/NP assist | $17.38 | $20.89 | $28.18 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 6th of 51
$138
AK $182VA $60.26
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.