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 $194.98 Median $1,000.00 Typical High $7,943.28 | Facility | None | $194.98 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | None | $194.98 | $194.98 | $316.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $3,981.07 Typical High $10,232.93 | Facility | None | $2,570.40 | $3,981.07 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $537.03 | Professional | None | $229.09 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,548.13 | Facility | None | $602.56 | $2,187.76 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $204.17 Median $1,412.54 Typical High $3,019.95 | Facility | None | $204.17 | $1,412.54 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $588.84 | Professional | None | $199.53 | $295.12 | $588.84 |
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 $95.50 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | 53 · Discontinued | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $97.72 Typical High $263.03 | Professional | 51 · Multiple procedures | $97.72 | $97.72 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $39.81 Typical High $104.71 | Professional | 80 · Assistant surgeon | $39.81 | $39.81 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $27.54 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $27.54 | $27.54 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $27.54 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $27.54 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $27.54 Typical High $74.13 | Professional | AS · PA/NP assist | $27.54 | $27.54 | $74.13 |
Where North Carolina sits
The same service costs 19.5 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· 23rd of 51
$380
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.