How much rates vary
Facilitymedian $117 · 10th to 90th $93 to $170Professionalmedian $182 · 10th to 90th $110 to $269
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 $93.33 Median $117.49 Typical High $158.49 | Facility | None | $93.33 | $117.49 | $158.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $120.23 Typical High $169.82 | Professional | None (both parts) | $91.20 | $120.23 | $169.82 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $112.20 Median $165.96 Typical High $213.80 | Professional | None (both parts) | $112.20 | $165.96 | $213.80 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $131.83 Median $199.53 Typical High $281.84 | Professional | None (both parts) | $131.83 | $199.53 | $281.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $120.23 Typical High $186.21 | Professional | None (both parts) | $93.33 | $120.23 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $169.82 | Professional | None | $117.49 | $147.91 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $141.25 Typical High $181.97 | Facility | None | $93.33 | $141.25 | $181.97 |
Medcost Setting Professional Modifier None (both parts) Typical Low $100.00 Median $134.90 Typical High $154.88 | Professional | None (both parts) | $100.00 | $134.90 | $154.88 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | None (both parts) | $91.20 | $109.65 | $128.82 |
United Setting Professional Modifier None (both parts) Typical Low $85.11 Median $109.65 Typical High $173.78 | Professional | None (both parts) | $85.11 | $109.65 | $173.78 |
16 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 Facility Modifier 52 · Reduced service Typical Low $46.77 Median $53.70 Typical High $58.88 | Facility | 52 · Reduced service | $46.77 | $53.70 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $15.85 Typical High $17.38 | Facility | 55 · Aftercare only | $13.80 | $15.85 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $11.75 | Facility | 56 · Pre-op care only | $9.33 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $46.77 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $11.75 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 24 · Unrelated visit after surgery | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $128.82 Median $169.82 Typical High $213.80 | Professional | 25 · Same-day visit | $128.82 | $169.82 | $213.80 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $53.70 Typical High $61.66 | Professional | 26 · Professional part | $43.65 | $53.70 | $61.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $204.17 Typical High $239.88 | Professional | 50 · Both sides | $151.36 | $204.17 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $67.61 Typical High $81.28 | Professional | 51 · Multiple procedures | $50.12 | $67.61 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $26.92 Typical High $32.36 | Professional | 80 · Assistant surgeon | $19.95 | $26.92 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.13 Median $19.05 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $14.13 | $19.05 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.13 Median $19.05 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $14.13 | $19.05 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $19.05 Typical High $22.39 | Professional | AS · PA/NP assist | $14.13 | $19.05 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $66.07 Median $81.28 Typical High $93.33 | Professional | TC · Technical part | $66.07 | $81.28 | $93.33 |
Where North Carolina sits
The same service costs 2.5 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· 2nd of 51
$182
AK $204AL $83.18
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.