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 $1,737.80 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,737.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $6,025.60 | Professional | None | $2,818.38 | $4,466.84 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,818.38 | Facility | None | $1,737.80 | $1,862.09 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,949.84 | $3,162.28 |
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 $1,949.84 Median $3,090.30 Typical High $4,570.88 | Professional | None | $1,949.84 | $3,090.30 | $4,570.88 |
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 $794.33 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $794.33 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $173.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $977.24 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $588.84 | $977.24 | $2,630.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $389.05 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $234.42 | $389.05 | $1,047.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $275.42 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $165.96 | $275.42 | $724.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $275.42 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $275.42 | $724.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $275.42 Typical High $724.44 | Professional | AS · PA/NP assist | $165.96 | $275.42 | $724.44 |
Where North Carolina sits
The same service costs 5.8 times more in California 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· 7th of 51
$3,236
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.