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 $77.62 Median $77.62 Typical High $7,943.28 | Facility | None | $77.62 | $77.62 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | None | $77.62 | $77.62 | $89.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $251.19 | Professional | None | $100.00 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $31,622.78 | Facility | None | $501.19 | $1,995.26 | $31,622.78 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $81.28 Typical High $123.03 | Facility | None | $77.62 | $81.28 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $676.08 Typical High $1,148.15 | Professional | None | $52.48 | $676.08 | $1,148.15 |
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 $79.43 Median $125.89 Typical High $446.68 | Professional | None | $79.43 | $125.89 | $446.68 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $338.84 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $26.30 | $338.84 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $134.90 Typical High $416.87 | Professional | 80 · Assistant surgeon | $10.47 | $134.90 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $93.33 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $7.41 | $93.33 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $93.33 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $93.33 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $93.33 Typical High $295.12 | Professional | AS · PA/NP assist | $7.41 | $93.33 | $295.12 |
Where North Carolina sits
The same service costs 30.9 times more in California than in Idaho. 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· 41st of 51
$174
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.