How much rates vary
Facilitymedian $174 · 10th to 90th $148 to $204Professionalmedian $282 · 10th to 90th $155 to $407
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 $147.91 Median $169.82 Typical High $194.98 | Facility | None | $147.91 | $169.82 | $194.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $134.90 Median $165.96 Typical High $199.53 | Professional | None (both parts) | $134.90 | $165.96 | $199.53 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $112.20 Median $213.80 Typical High $323.59 | Professional | None (both parts) | $112.20 | $213.80 | $323.59 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $295.12 Typical High $416.87 | Professional | None (both parts) | $199.53 | $295.12 | $416.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $141.25 Median $181.97 Typical High $288.40 | Professional | None (both parts) | $141.25 | $181.97 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $239.88 | Professional | None | $165.96 | $208.93 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $251.19 | Facility | None | $147.91 | $194.98 | $251.19 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $199.53 Typical High $223.87 | Professional | None (both parts) | $128.82 | $199.53 | $223.87 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $131.83 Median $154.88 Typical High $194.98 | Professional | None (both parts) | $131.83 | $154.88 | $194.98 |
United Setting Professional Modifier None (both parts) Typical Low $134.90 Median $162.18 Typical High $257.04 | Professional | None (both parts) | $134.90 | $162.18 | $257.04 |
18 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 $74.13 Median $85.11 Typical High $87.10 | Facility | 52 · Reduced service | $74.13 | $85.11 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $26.30 | Facility | 55 · Aftercare only | $22.39 | $25.70 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $17.38 | Facility | 56 · Pre-op care only | $14.79 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $17.38 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 24 · Unrelated visit after surgery | $213.80 | $213.80 | $213.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $213.80 Median $251.19 Typical High $323.59 | Professional | 25 · Same-day visit | $213.80 | $251.19 | $323.59 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $213.80 Median $213.80 Typical High $323.59 | Professional | 57 · Decision for surgery | $213.80 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | KX · Policy requirements met | $251.19 | $251.19 | $251.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $81.28 Typical High $89.13 | Professional | 26 · Professional part | $66.07 | $81.28 | $89.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $302.00 Typical High $338.84 | Professional | 50 · Both sides | $213.80 | $302.00 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $100.00 Typical High $112.20 | Professional | 51 · Multiple procedures | $70.79 | $100.00 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $39.81 Typical High $44.67 | Professional | 80 · Assistant surgeon | $28.84 | $39.81 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $28.18 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $19.95 | $28.18 | $31.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $28.18 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $28.18 | $31.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $28.18 Typical High $31.62 | Professional | AS · PA/NP assist | $19.95 | $28.18 | $31.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | TC · Technical part | $100.00 | $120.23 | $131.83 |
Where North Carolina sits
The same service costs 2.3 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
$282
AK $288AL $123
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.