How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,202 to $15,136Professionalmedian $813 · 10th to 90th $447 to $1,349
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 $1,230.27 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,230.27 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $2,398.83 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $323.59 Typical High $467.74 | Professional | 26 · Professional part | $323.59 | $323.59 | $467.74 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 26 · Professional part | $524.81 | $524.81 | $524.81 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $467.74 Median $758.58 Typical High $1,023.29 | Professional | None (both parts) | $467.74 | $758.58 | $1,023.29 |
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 None (both parts) Typical Low $1,230.27 Median $2,754.23 Typical High $3,235.94 | Professional | None (both parts) | $1,230.27 | $2,754.23 | $3,235.94 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $371.54 Median $478.63 Typical High $933.25 | Professional | 26 · Professional part | $371.54 | $478.63 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,318.26 | $1,995.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $549.54 Median $1,348.96 Typical High $2,041.74 | Professional | None (both parts) | $549.54 | $1,348.96 | $2,041.74 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $354.81 Typical High $616.60 | Professional | 26 · Professional part | $302.00 | $354.81 | $616.60 |
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 $338.84 Median $512.86 Typical High $3,311.31 | Professional | None (both parts) | $338.84 | $512.86 | $3,311.31 |
United Setting Professional Modifier 26 · Professional part Typical Low $338.84 Median $478.63 Typical High $870.96 | Professional | 26 · Professional part | $338.84 | $478.63 | $870.96 |
13 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 $616.60 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $125.89 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | TC · Technical part | $912.01 | $912.01 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $676.08 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $436.52 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $269.15 Typical High $588.84 | Professional | 80 · Assistant surgeon | $177.83 | $269.15 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $190.55 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $123.03 | $190.55 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $190.55 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $190.55 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $190.55 Typical High $407.38 | Professional | AS · PA/NP assist | $123.03 | $190.55 | $407.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $870.96 Median $1,000.00 Typical High $1,698.24 | Professional | TC · Technical part | $870.96 | $1,000.00 | $1,698.24 |
United Setting Professional Modifier TC · Technical part Typical Low $1,096.48 Median $2,454.71 Typical High $3,548.13 | Professional | TC · Technical part | $1,096.48 | $2,454.71 | $3,548.13 |
Where North Carolina sits
The same service costs 14.5 times more in California than in Maine. 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· 44th of 51
$912
CA $8,128ME $562
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.