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 $1,288.25 Median $1,318.26 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,318.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,318.26 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $4,365.16 | Professional | None | $1,995.26 | $3,235.94 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $29,512.09 | Facility | None | $478.63 | $870.96 | $29,512.09 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,137.96 | Facility | None | $1,318.26 | $1,412.54 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,290.87 | Professional | None | $891.25 | $1,380.38 | $2,290.87 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,380.38 | $2,238.72 | $4,073.80 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $676.08 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $446.68 | $676.08 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $275.42 Typical High $794.33 | Professional | 80 · Assistant surgeon | $181.97 | $275.42 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $190.55 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $125.89 | $190.55 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $190.55 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $190.55 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $190.55 Typical High $549.54 | Professional | AS · PA/NP assist | $125.89 | $190.55 | $549.54 |
Where North Carolina sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 9th of 51
$2,399
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.