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 $199.53 Median $1,288.25 Typical High $8,317.64 | Facility | None | $199.53 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | None | $199.53 | $199.53 | $234.42 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $501.19 | Professional | None | $100.00 | $223.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $2,187.76 | Facility | None | $478.63 | $602.56 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $316.23 | Facility | None | $199.53 | $208.93 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | None | $134.90 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $426.58 | Professional | None | $194.98 | $234.42 | $426.58 |
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 $100.00 Median $100.00 Typical High $104.71 | Professional | 52 · Reduced service | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | 53 · Discontinued | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 54 · Surgery only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $97.72 Typical High $97.72 | Professional | 51 · Multiple procedures | $67.61 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $38.90 Typical High $38.90 | Professional | 80 · Assistant surgeon | $27.54 | $38.90 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $19.05 | $27.54 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $27.54 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | AS · PA/NP assist | $19.05 | $27.54 | $27.54 |
Where North Carolina sits
The same service costs 18.6 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· 34th of 51
$224
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.