How much rates vary
Facilitymedian $214 · 10th to 90th $182 to $269Professionalmedian $355 · 10th to 90th $200 to $501
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 $181.97 Median $213.80 Typical High $257.04 | Facility | None | $181.97 | $213.80 | $257.04 |
Aetna Setting Professional Modifier None (both parts) Typical Low $173.78 Median $213.80 Typical High $257.04 | Professional | None (both parts) | $173.78 | $213.80 | $257.04 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $223.87 Median $263.03 Typical High $338.84 | Professional | None (both parts) | $223.87 | $263.03 | $338.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $269.15 Median $380.19 Typical High $512.86 | Professional | None (both parts) | $269.15 | $380.19 | $512.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $186.21 Median $229.09 Typical High $354.81 | Professional | None (both parts) | $186.21 | $229.09 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $398.11 | Professional | None | $213.80 | $269.15 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $309.03 | Facility | None | $181.97 | $257.04 | $309.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $165.96 Median $245.47 Typical High $288.40 | Professional | None (both parts) | $165.96 | $245.47 | $288.40 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None (both parts) | $169.82 | $204.17 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $169.82 Median $204.17 Typical High $323.59 | Professional | None (both parts) | $169.82 | $204.17 | $323.59 |
15 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 $91.20 Median $104.71 Typical High $107.15 | Facility | 52 · Reduced service | $91.20 | $104.71 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $31.62 | Facility | 55 · Aftercare only | $27.54 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $21.38 | Facility | 56 · Pre-op care only | $18.20 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $91.20 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $21.38 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | 25 · Same-day visit | $263.03 | $309.03 | $389.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $97.72 Typical High $114.82 | Professional | 26 · Professional part | $79.43 | $97.72 | $114.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $371.54 Typical High $436.52 | Professional | 50 · Both sides | $281.84 | $371.54 | $436.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $123.03 Typical High $144.54 | Professional | 51 · Multiple procedures | $95.50 | $123.03 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $48.98 Typical High $57.54 | Professional | 80 · Assistant surgeon | $38.02 | $48.98 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $34.67 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $26.30 | $34.67 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $34.67 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $34.67 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $34.67 Typical High $40.74 | Professional | AS · PA/NP assist | $26.30 | $34.67 | $40.74 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $120.23 Median $147.91 Typical High $173.78 | Professional | TC · Technical part | $120.23 | $147.91 | $173.78 |
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· 2nd of 51
$355
AK $380AL $158
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.