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 $371.54 Median $1,148.15 Typical High $7,943.28 | Facility | None | $371.54 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $1,148.15 | Professional | None | $338.84 | $371.54 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,862.09 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $75.86 Median $758.58 Typical High $1,288.25 | Professional | None | $75.86 | $758.58 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $3,235.94 | Facility | None | $398.11 | $1,445.44 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $676.08 | Professional | None | $251.19 | $363.08 | $676.08 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,023.29 | Professional | None | $436.52 | $691.83 | $1,023.29 |
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 $165.96 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $181.97 Typical High $512.86 | Professional | 51 · Multiple procedures | $125.89 | $181.97 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $72.44 Typical High $204.17 | Professional | 80 · Assistant surgeon | $51.29 | $72.44 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $51.29 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $35.48 | $51.29 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $51.29 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $51.29 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $51.29 Typical High $144.54 | Professional | AS · PA/NP assist | $35.48 | $51.29 | $144.54 |
Where North Carolina sits
The same service costs 8.1 times more in Texas 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· 32nd of 51
$759
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.