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 $1,047.13 Median $1,584.89 Typical High $10,964.78 | Facility | None | $1,047.13 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,047.13 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $8,511.38 Median $14,125.38 Typical High $21,877.62 | Facility | None | $8,511.38 | $14,125.38 | $21,877.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $2,089.30 Typical High $3,090.30 | Professional | None | $100.00 | $2,089.30 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,454.71 | Facility | None | $478.63 | $645.65 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $22,908.68 Typical High $32,359.37 | Facility | None | $1,047.13 | $22,908.68 | $32,359.37 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,819.70 | Professional | None | $724.44 | $1,047.13 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,698.24 | $2,884.03 |
9 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 $501.19 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $104.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $524.81 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $354.81 | $524.81 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $208.93 Typical High $562.34 | Professional | 80 · Assistant surgeon | $144.54 | $208.93 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $147.91 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $100.00 | $147.91 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $147.91 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $147.91 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $147.91 Typical High $389.05 | Professional | AS · PA/NP assist | $100.00 | $147.91 | $389.05 |
Where North Carolina sits
The same service costs 18.2 times more in California 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· 29th of 51
$1,950
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.