How much rates vary
Facilitymedian $2,818 · 10th to 90th $89 to $7,079Professionalmedian $302 · 10th to 90th $95 to $776
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 $89.13 Median $691.83 Typical High $5,248.07 | Facility | None | $89.13 | $691.83 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $691.83 | Professional | None | $89.13 | $173.78 | $691.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $123.03 Median $363.08 Typical High $776.25 | Professional | None | $123.03 | $363.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $758.58 | Professional | None | $102.33 | $199.53 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | None | $208.93 | $263.03 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $794.33 | Facility | None | $87.10 | $89.13 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $524.81 | Professional | None | $186.21 | $239.88 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $1,513.56 | Professional | None | $83.18 | $190.55 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $4,365.16 Typical High $7,244.36 | Facility | None | $1,995.26 | $4,365.16 | $7,244.36 |
United Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $794.33 | Professional | None | $87.10 | $194.98 | $794.33 |
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 $44.67 Median $74.13 Typical High $346.74 | Professional | 52 · Reduced service | $44.67 | $74.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $30.20 Typical High $138.04 | Professional | 53 · Discontinued | $17.78 | $30.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $112.20 Typical High $524.81 | Professional | 54 · Surgery only | $67.61 | $112.20 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $22.39 Typical High $104.71 | Professional | 55 · Aftercare only | $13.49 | $22.39 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $15.14 Typical High $69.18 | Professional | 56 · Pre-op care only | $8.91 | $15.14 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $120.23 Typical High $263.03 | Professional | 51 · Multiple procedures | $93.33 | $120.23 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $47.86 Typical High $104.71 | Professional | 80 · Assistant surgeon | $37.15 | $47.86 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $33.11 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $26.30 | $33.11 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $33.11 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $33.11 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $33.11 Typical High $74.13 | Professional | AS · PA/NP assist | $26.30 | $33.11 | $74.13 |
Where North Carolina sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 19th of 51
$302
WA $933DC $97.72
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.