How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,202 to $15,136Professionalmedian $501 · 10th to 90th $282 to $832
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 $1,288.25 Median $5,248.07 Typical High $12,302.69 | Facility | None | $1,288.25 | $5,248.07 | $12,302.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $5,248.07 Typical High $15,135.61 | Professional | None (both parts) | $1,288.25 | $5,248.07 | $15,135.61 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 26 · Professional part | $263.03 | $263.03 | $275.42 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $389.05 Median $630.96 Typical High $831.76 | Professional | None (both parts) | $389.05 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $16,595.87 | Facility | None | $13,182.57 | $13,182.57 | $16,595.87 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $398.11 Typical High $776.25 | Professional | 26 · Professional part | $302.00 | $398.11 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $426.58 | Facility | None | $263.03 | $295.12 | $426.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $204.17 Median $281.84 Typical High $426.58 | Professional | None (both parts) | $204.17 | $281.84 | $426.58 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $281.84 Typical High $512.86 | Professional | 26 · Professional part | $251.19 | $281.84 | $512.86 |
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 (both parts) Typical Low $275.42 Median $389.05 Typical High $724.44 | Professional | None (both parts) | $275.42 | $389.05 | $724.44 |
United Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $389.05 Typical High $724.44 | Professional | 26 · Professional part | $275.42 | $389.05 | $724.44 |
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 $131.83 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | 53 · Discontinued | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 54 · Surgery only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $27.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $141.25 Typical High $363.08 | Professional | 51 · Multiple procedures | $102.33 | $141.25 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $56.23 Typical High $144.54 | Professional | 80 · Assistant surgeon | $41.69 | $56.23 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $39.81 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $28.84 | $39.81 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $39.81 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $39.81 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $39.81 Typical High $102.33 | Professional | AS · PA/NP assist | $28.84 | $39.81 | $102.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $169.82 Typical High $309.03 | Professional | TC · Technical part | $151.36 | $169.82 | $309.03 |
Where North Carolina sits
The same service costs 19.5 times more in Colorado 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.
North Carolina· 34th of 51
$631
CO $6,761MD $347
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.