How much rates vary
Facilitymedian $10,233 · 10th to 90th $525 to $26,303Professionalmedian $339 · 10th to 90th $186 to $575
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 $186.21 Median $1,584.89 Typical High $11,481.54 | Facility | None | $186.21 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $1,995.26 | Professional | None (both parts) | $186.21 | $186.21 | $1,995.26 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 26 · Professional part | $186.21 | $186.21 | $213.80 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $269.15 Median $446.68 Typical High $602.56 | Professional | None (both parts) | $269.15 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $13,182.57 Median $26,302.68 Typical High $35,481.34 | Facility | None | $13,182.57 | $26,302.68 | $35,481.34 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $281.84 Typical High $537.03 | Professional | 26 · Professional part | $213.80 | $281.84 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $213.80 Typical High $302.00 | Facility | None | $186.21 | $213.80 | $302.00 |
Medcost Setting Professional Modifier None (both parts) Typical Low $147.91 Median $204.17 Typical High $309.03 | Professional | None (both parts) | $147.91 | $204.17 | $309.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $204.17 Typical High $363.08 | Professional | 26 · Professional part | $177.83 | $204.17 | $363.08 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $281.84 Typical High $512.86 | Professional | None (both parts) | $194.98 | $281.84 | $512.86 |
United Setting Professional Modifier 26 · Professional part Typical Low $194.98 Median $281.84 Typical High $512.86 | Professional | 26 · Professional part | $194.98 | $281.84 | $512.86 |
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 $93.33 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 54 · Surgery only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $102.33 Typical High $257.04 | Professional | 51 · Multiple procedures | $74.13 | $102.33 | $257.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $40.74 Typical High $102.33 | Professional | 80 · Assistant surgeon | $29.51 | $40.74 | $102.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $28.84 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $20.42 | $28.84 | $72.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $28.84 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $28.84 | $72.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $28.84 Typical High $72.44 | Professional | AS · PA/NP assist | $20.42 | $28.84 | $72.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $107.15 Median $123.03 Typical High $213.80 | Professional | TC · Technical part | $107.15 | $123.03 | $213.80 |
Where North Carolina sits
The same service costs 28.8 times more in Colorado 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· 34th of 51
$417
CO $7,079KY $245
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.