How much rates vary
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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $75.86 | Professional | None | $15.85 | $15.85 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $63.10 | Professional | None | $33.11 | $43.65 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $199.53 Typical High $199.53 | Professional | None | $18.20 | $199.53 | $199.53 |
Medcost Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.60 | Facility | None | $15.85 | $15.85 | $16.60 |
Medcost Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $15.49 | Professional | None | $10.72 | $15.49 | $15.49 |
United Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $2,089.30 | Facility | None | $512.86 | $891.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $40.74 | Professional | None | $14.45 | $18.20 | $40.74 |
9 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 $7.94 Median $7.94 Typical High $11.22 | Professional | 52 · Reduced service | $7.94 | $7.94 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $4.47 | Professional | 53 · Discontinued | $3.16 | $3.16 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $3.39 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $2.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.37 Median $7.59 Typical High $7.59 | Professional | 51 · Multiple procedures | $5.37 | $7.59 | $7.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.14 Median $3.09 Typical High $3.09 | Professional | 80 · Assistant surgeon | $2.14 | $3.09 | $3.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | 81 · Minimal assistant surgeon | $1.51 | $2.14 | $2.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | 82 · Assistant surgeon, no resident | $1.51 | $2.14 | $2.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | AS · PA/NP assist | $1.51 | $2.14 | $2.14 |
Where North Carolina sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 13th of 51
$39.81
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.