How much rates vary
Facilitymedian $22,387 · 10th to 90th $1,288 to $44,668Professionalmedian $1,413 · 10th to 90th $832 to $2,291
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 $812.83 Median $1,071.52 Typical High $15,135.61 | Facility | None | $812.83 | $1,071.52 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,778.28 | Professional | None | $794.33 | $812.83 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,659.59 | Professional | None | $977.24 | $1,148.15 | $1,659.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19,054.61 Median $31,622.78 Typical High $48,977.88 | Facility | None | $19,054.61 | $31,622.78 | $48,977.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,698.24 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $22,387.21 Median $32,359.37 Typical High $46,773.51 | Facility | None | $22,387.21 | $32,359.37 | $46,773.51 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,290.87 | Professional | None | $912.01 | $1,202.26 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $72,443.60 | Facility | None | $812.83 | $1,548.82 | $72,443.60 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,412.54 | Professional | None | $676.08 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $13,489.63 Typical High $36,307.81 | Facility | None | $1,621.81 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,238.72 | Professional | None | $831.76 | $1,288.25 | $2,238.72 |
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 $407.38 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $467.74 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $338.84 | $467.74 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $186.21 Typical High $478.63 | Professional | 80 · Assistant surgeon | $134.90 | $186.21 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $128.82 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $95.50 | $128.82 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $128.82 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $128.82 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $128.82 Typical High $331.13 | Professional | AS · PA/NP assist | $95.50 | $128.82 | $331.13 |
Where North Carolina sits
The same service costs 13.8 times more in Vermont 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
VT $33,708MT $2,434
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.