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 $389.05 Median $389.05 Typical High $7,943.28 | Facility | None | $389.05 | $389.05 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | None | $389.05 | $389.05 | $549.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $489.78 | Professional | None | $208.93 | $288.40 | $489.78 |
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 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,000.00 | Professional | None | $467.74 | $588.84 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $630.96 | Facility | None | $245.47 | $389.05 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $676.08 | Professional | None | $281.84 | $426.58 | $676.08 |
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 $177.83 Median $407.38 Typical High $588.84 | Professional | None | $177.83 | $407.38 | $588.84 |
8 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 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | 54 · Surgery only | $295.12 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $54.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $269.15 Typical High $549.54 | Professional | 51 · Multiple procedures | $141.25 | $269.15 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $107.15 Typical High $218.78 | Professional | 80 · Assistant surgeon | $56.23 | $107.15 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $74.13 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $39.81 | $74.13 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $74.13 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $74.13 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $74.13 Typical High $154.88 | Professional | AS · PA/NP assist | $39.81 | $74.13 | $154.88 |
Where North Carolina sits
The same service costs 7.1 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· 50th of 51
$389
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.