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 $234.42 Median $1,288.25 Typical High $10,471.29 | Facility | None | $234.42 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $1,288.25 | Professional | None | $234.42 | $234.42 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $14,791.08 | Facility | None | $5,754.40 | $9,332.54 | $14,791.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $562.34 | Professional | None | $63.10 | $83.18 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,232.93 Typical High $16,982.44 | Facility | None | $602.56 | $10,232.93 | $16,982.44 |
Medcost Setting Facility Modifier None Typical Low $251.19 Median $8,912.51 Typical High $19,952.62 | Facility | None | $251.19 | $8,912.51 | $19,952.62 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $316.23 Typical High $602.56 | Professional | None | $81.28 | $316.23 | $602.56 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $912.01 | Professional | None | $50.12 | $79.43 | $912.01 |
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 $117.49 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $117.49 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $177.83 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $158.49 Typical High $436.52 | Professional | 51 · Multiple procedures | $66.07 | $158.49 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $63.10 Typical High $177.83 | Professional | 80 · Assistant surgeon | $26.30 | $63.10 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $43.65 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $18.62 | $43.65 | $123.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $43.65 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $43.65 | $123.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $43.65 Typical High $123.03 | Professional | AS · PA/NP assist | $18.62 | $43.65 | $123.03 |
Where North Carolina sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 47th of 51
$145
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.