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 $275.42 Median $275.42 Typical High $7,943.28 | Facility | None | $275.42 | $275.42 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | None | $275.42 | $275.42 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $831.76 | Professional | None | $426.58 | $676.08 | $831.76 |
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 $338.84 Median $416.87 Typical High $776.25 | Professional | None | $338.84 | $416.87 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $1,318.26 | Facility | None | $275.42 | $331.13 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $562.34 | Professional | None | $275.42 | $371.54 | $562.34 |
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 $281.84 Median $416.87 Typical High $758.58 | Professional | None | $281.84 | $416.87 | $758.58 |
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 $138.04 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $54.95 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $208.93 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $35.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $190.55 Typical High $407.38 | Professional | 51 · Multiple procedures | $138.04 | $190.55 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $75.86 Typical High $162.18 | Professional | 80 · Assistant surgeon | $54.95 | $75.86 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $53.70 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $38.90 | $53.70 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $53.70 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $53.70 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $53.70 Typical High $114.82 | Professional | AS · PA/NP assist | $38.90 | $53.70 | $114.82 |
Where North Carolina sits
The same service costs 3.9 times more in Wisconsin 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· 11th of 51
$575
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.