How much rates vary
Facilitymedian $98 · 10th to 90th $69 to $129Professionalmedian $112 · 10th to 90th $71 to $166
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 $69.18 Median $97.72 Typical High $128.82 | Facility | None | $69.18 | $97.72 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $128.82 | Professional | None | $64.57 | $97.72 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $125.89 | Professional | None | $63.10 | $91.20 | $125.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $169.82 | Professional | None | $91.20 | $125.89 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $151.36 | Professional | None | $58.88 | $89.13 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $138.04 | Facility | None | $114.82 | $114.82 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $128.82 | Professional | None | $61.66 | $75.86 | $128.82 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $162.18 | Professional | None | $74.13 | $123.03 | $162.18 |
United Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $154.88 | Professional | None | $61.66 | $77.62 | $154.88 |
12 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 $28.84 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $28.84 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.71 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.75 | $6.92 | $6.92 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $67.61 Median $100.00 Typical High $107.15 | Professional | 24 · Unrelated visit after surgery | $67.61 | $100.00 | $107.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $57.54 Median $95.50 Typical High $120.23 | Professional | 25 · Same-day visit | $57.54 | $95.50 | $120.23 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $67.61 Median $85.11 Typical High $120.23 | Professional | 57 · Decision for surgery | $67.61 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $57.54 Median $112.20 Typical High $112.20 | Professional | FS · Shared visit | $57.54 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $38.02 Typical High $97.72 | Professional | 51 · Multiple procedures | $30.90 | $38.02 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $15.14 Typical High $38.90 | Professional | 80 · Assistant surgeon | $12.30 | $15.14 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.71 Median $10.47 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $8.71 | $10.47 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.71 Median $10.47 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $8.71 | $10.47 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.71 Median $10.47 Typical High $27.54 | Professional | AS · PA/NP assist | $8.71 | $10.47 | $27.54 |
Where North Carolina sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 11th of 51
$112
AK $155AL $64.57
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.