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 $407.38 Median $407.38 Typical High $7,943.28 | Facility | None | $407.38 | $407.38 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | None | $407.38 | $407.38 | $575.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,258.93 | Professional | None | $562.34 | $891.25 | $1,258.93 |
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 $549.54 Median $616.60 Typical High $1,230.27 | Professional | None | $549.54 | $616.60 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $426.58 Typical High $660.69 | Facility | None | $407.38 | $426.58 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $707.95 | Professional | None | $389.05 | $616.60 | $707.95 |
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 $426.58 Median $691.83 Typical High $1,122.02 | Professional | None | $426.58 | $691.83 | $1,122.02 |
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 $204.17 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $52.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $309.03 Typical High $602.56 | Professional | 51 · Multiple procedures | $194.98 | $309.03 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $123.03 Typical High $239.88 | Professional | 80 · Assistant surgeon | $77.62 | $123.03 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $85.11 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $54.95 | $85.11 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $85.11 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $85.11 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $85.11 Typical High $169.82 | Professional | AS · PA/NP assist | $54.95 | $85.11 | $169.82 |
Where North Carolina sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 9th of 51
$851
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.