How much rates vary
Facilitymedian $251 · 10th to 90th $81 to $2,344Professionalmedian $661 · 10th to 90th $427 to $1,202
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 $380.19 Median $1,000.00 Typical High $7,943.28 | Facility | None | $380.19 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $724.44 | Professional | None | $380.19 | $380.19 | $724.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,258.93 | Professional | None | $660.69 | $794.33 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $10,715.19 Median $31,622.78 Typical High $32,359.37 | Facility | None | $10,715.19 | $31,622.78 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,096.48 | Professional | None | $467.74 | $575.44 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $616.60 | Facility | None | $380.19 | $380.19 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $676.08 | Professional | None | $302.00 | $512.86 | $676.08 |
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 $398.11 Median $588.84 Typical High $1,096.48 | Professional | None | $398.11 | $588.84 | $1,096.48 |
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 $190.55 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $39.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $257.04 Typical High $562.34 | Professional | 51 · Multiple procedures | $151.36 | $257.04 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $102.33 Typical High $229.09 | Professional | 80 · Assistant surgeon | $60.26 | $102.33 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $72.44 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $41.69 | $72.44 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $72.44 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $72.44 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $72.44 Typical High $158.49 | Professional | AS · PA/NP assist | $41.69 | $72.44 | $158.49 |
Where North Carolina sits
The same service costs 27.0 times more in Alabama than in Maryland. 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
AL $15,422MD $571
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.