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 $257.04 Typical High $7,413.10 | Facility | None | $77.62 | $257.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $229.09 Typical High $257.04 | Professional | None | $77.62 | $229.09 | $257.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $776.25 | Professional | None | $134.90 | $257.04 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $309.03 Typical High $512.86 | Professional | None | $104.71 | $309.03 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $416.87 | Facility | None | $74.13 | $125.89 | $416.87 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $398.11 | Professional | None | $275.42 | $380.19 | $398.11 |
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 $83.18 Median $239.88 Typical High $524.81 | Professional | None | $83.18 | $239.88 | $524.81 |
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 $38.90 Median $100.00 Typical High $128.82 | Professional | 52 · Reduced service | $38.90 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $15.85 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $58.88 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $11.75 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $19.95 | $25.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $190.55 Typical High $371.54 | Professional | 51 · Multiple procedures | $173.78 | $190.55 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $75.86 Typical High $147.91 | Professional | 80 · Assistant surgeon | $70.79 | $75.86 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $48.98 Median $52.48 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $48.98 | $52.48 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $48.98 Median $52.48 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $48.98 | $52.48 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $52.48 Typical High $104.71 | Professional | AS · PA/NP assist | $48.98 | $52.48 | $104.71 |
Where North Carolina sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 19th of 51
$257
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.