How much rates vary
Facilitymedian $4,786 · 10th to 90th $646 to $10,471Professionalmedian $3,236 · 10th to 90th $295 to $7,762
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 $239.88 Median $2,818.38 Typical High $5,248.07 | Facility | None | $239.88 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,584.89 Typical High $3,388.44 | Professional | None | $239.88 | $1,584.89 | $3,388.44 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $6,025.60 Typical High $6,025.60 | Professional | None | $109.65 | $6,025.60 | $6,025.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $5,888.44 Typical High $9,332.54 | Facility | None | $3,630.78 | $5,888.44 | $9,332.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $4,073.80 Typical High $8,709.64 | Professional | None | $363.08 | $4,073.80 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,165.95 Typical High $10,232.93 | Facility | None | $602.56 | $6,165.95 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $3,311.31 Typical High $5,754.40 | Professional | None | $302.00 | $3,311.31 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $4,786.30 Typical High $9,549.93 | Facility | None | $288.40 | $4,786.30 | $9,549.93 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,801.89 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,801.89 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $245.47 Median $1,995.26 Typical High $6,309.57 | Professional | None | $245.47 | $1,995.26 | $6,309.57 |
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 $117.49 Median $186.21 Typical High $1,479.11 | Professional | 52 · Reduced service | $117.49 | $186.21 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $74.13 Typical High $588.84 | Professional | 53 · Discontinued | $47.86 | $74.13 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $275.42 Typical High $2,187.76 | Professional | 54 · Surgery only | $177.83 | $275.42 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $436.52 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $37.15 Typical High $295.12 | Professional | 56 · Pre-op care only | $23.99 | $37.15 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,905.46 Median $1,905.46 Typical High $4,073.80 | Professional | 51 · Multiple procedures | $1,905.46 | $1,905.46 | $4,073.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $758.58 Median $758.58 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $758.58 | $758.58 | $1,621.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | 81 · Minimal assistant surgeon | $524.81 | $524.81 | $1,122.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | 82 · Assistant surgeon, no resident | $524.81 | $524.81 | $1,122.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | AS · PA/NP assist | $524.81 | $524.81 | $1,122.02 |
Where North Carolina sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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
$3,388
AK $5,248NE $468
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.