How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,288 to $21,878Professionalmedian $1,175 · 10th to 90th $661 to $1,950
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 $645.65 Median $1,584.89 Typical High $16,595.87 | Facility | None | $645.65 | $1,584.89 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,548.82 | Professional | None | $645.65 | $660.69 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $7,943.28 Median $12,882.50 Typical High $19,952.62 | Facility | None | $7,943.28 | $12,882.50 | $19,952.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,949.84 | Professional | None | $977.24 | $1,380.38 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $14,125.38 Typical High $27,542.29 | Facility | None | $9,120.11 | $14,125.38 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,819.70 | Professional | None | $741.31 | $954.99 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $29,512.09 | Facility | None | $707.95 | $1,258.93 | $29,512.09 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,122.02 | Professional | None | $562.34 | $758.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $19,498.45 | Facility | None | $1,380.38 | $4,365.16 | $19,498.45 |
United Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,778.28 | Professional | None | $660.69 | $933.25 | $1,778.28 |
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 $323.59 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $66.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $380.19 Typical High $933.25 | Professional | 51 · Multiple procedures | $275.42 | $380.19 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $151.36 Typical High $380.19 | Professional | 80 · Assistant surgeon | $112.20 | $151.36 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $77.62 Median $107.15 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $77.62 | $107.15 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $77.62 Median $107.15 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $77.62 | $107.15 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $107.15 Typical High $263.03 | Professional | AS · PA/NP assist | $77.62 | $107.15 | $263.03 |
Where North Carolina sits
The same service costs 9.6 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $19,472MT $2,030
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.