How much rates vary
Facilitymedian $4,786 · 10th to 90th $646 to $13,490Professionalmedian $776 · 10th to 90th $372 to $1,202
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 $371.54 Median $371.54 Typical High $7,943.28 | Facility | None | $371.54 | $371.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $380.19 | Professional | None | $338.84 | $371.54 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $13,489.63 | Facility | None | $3,388.44 | $5,248.07 | $13,489.63 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,258.93 | Professional | None | $645.65 | $912.01 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $5,011.87 Typical High $10,964.78 | Facility | None | $407.38 | $5,011.87 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $602.56 | Professional | None | $389.05 | $389.05 | $602.56 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $851.14 | Professional | None | $316.23 | $426.58 | $851.14 |
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 $169.82 Median $181.97 Typical High $186.21 | Professional | 52 · Reduced service | $169.82 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $446.68 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $77.62 Typical High $177.83 | Professional | 80 · Assistant surgeon | $77.62 | $77.62 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $54.95 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $54.95 | $54.95 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $54.95 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $54.95 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $54.95 Typical High $125.89 | Professional | AS · PA/NP assist | $54.95 | $54.95 | $125.89 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in New York. 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· 4th of 51
$794
AK $1,479NY $331
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.