How much rates vary
Facilitymedian $129 · 10th to 90th $107 to $5,495Professionalmedian $204 · 10th to 90th $120 to $282
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 $107.15 Median $120.23 Typical High $162.18 | Facility | None | $107.15 | $120.23 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $162.18 | Professional | None | $95.50 | $114.82 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | None | $134.90 | $162.18 | $194.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $281.84 | Professional | None | $147.91 | $218.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $7,079.46 | Facility | None | $3,388.44 | $5,370.32 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $213.80 | Professional | None | $102.33 | $120.23 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $223.87 | Professional | None | $138.04 | $138.04 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $114.82 Typical High $151.36 | Facility | None | $107.15 | $114.82 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $162.18 | Professional | None | $93.33 | $125.89 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $295.12 | Professional | None | $112.20 | $199.53 | $295.12 |
United Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $213.80 | Professional | None | $95.50 | $114.82 | $213.80 |
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 $45.71 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $10.72 | $12.02 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $95.50 Median $95.50 Typical High $154.88 | Professional | 24 · Unrelated visit after surgery | $95.50 | $95.50 | $154.88 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $177.83 Typical High $295.12 | Professional | 25 · Same-day visit | $117.49 | $177.83 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $63.10 Typical High $93.33 | Professional | 51 · Multiple procedures | $46.77 | $63.10 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $25.12 Typical High $37.15 | Professional | 80 · Assistant surgeon | $18.62 | $25.12 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $17.78 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $13.18 | $17.78 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $17.78 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $17.78 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $17.78 Typical High $25.70 | Professional | AS · PA/NP assist | $13.18 | $17.78 | $25.70 |
Where North Carolina sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 5th of 51
$204
AK $263NJ $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.