How much rates vary
Facilitymedian $141 · 10th to 90th $66 to $1,288Professionalmedian $219 · 10th to 90th $102 to $468
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 $66.07 Median $186.21 Typical High $1,584.89 | Facility | None | $66.07 | $186.21 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $204.17 | Professional | None | $66.07 | $147.91 | $204.17 |
BCBS North Carolina Setting Facility Modifier None Typical Low $66.07 Median $79.43 Typical High $95.50 | Facility | None | $66.07 | $79.43 | $95.50 |
BCBS North Carolina Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $478.63 | Professional | None | $138.04 | $223.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $354.81 | Professional | None | $72.44 | $158.49 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $223.87 | Facility | None | $63.10 | $66.07 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $371.54 | Professional | None | $162.18 | $208.93 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $354.81 | Professional | None | $66.07 | $162.18 | $354.81 |
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 $33.11 Median $72.44 Typical High $93.33 | Professional | 52 · Reduced service | $33.11 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $28.84 Typical High $37.15 | Professional | 53 · Discontinued | $13.18 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $109.65 Typical High $141.25 | Professional | 54 · Surgery only | $48.98 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $21.88 Typical High $28.18 | Professional | 55 · Aftercare only | $9.77 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $14.45 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.61 | $14.45 | $18.62 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | GN · Speech therapy plan | $151.36 | $151.36 | $151.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $104.71 Typical High $275.42 | Professional | 51 · Multiple procedures | $79.43 | $104.71 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $42.66 Typical High $109.65 | Professional | 80 · Assistant surgeon | $32.36 | $42.66 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $29.51 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $22.39 | $29.51 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $29.51 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $29.51 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $29.51 Typical High $77.62 | Professional | AS · PA/NP assist | $22.39 | $29.51 | $77.62 |
Where North Carolina sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 7th of 51
$219
WA $288KY $100
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.