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 $457.09 Median $457.09 Typical High $7,943.28 | Facility | None | $457.09 | $457.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,380.38 | Professional | None | $630.96 | $977.24 | $1,380.38 |
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 $602.56 Median $691.83 Typical High $1,380.38 | Professional | None | $602.56 | $691.83 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $741.31 | Facility | None | $457.09 | $478.63 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $776.25 | Professional | None | $436.52 | $691.83 | $776.25 |
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 $467.74 Median $758.58 Typical High $1,258.93 | Professional | None | $467.74 | $758.58 | $1,258.93 |
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 $229.09 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $58.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $338.84 Typical High $676.08 | Professional | 51 · Multiple procedures | $218.78 | $338.84 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $138.04 Typical High $269.15 | Professional | 80 · Assistant surgeon | $87.10 | $138.04 | $269.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $95.50 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $60.26 | $95.50 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $95.50 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $95.50 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $95.50 Typical High $186.21 | Professional | AS · PA/NP assist | $60.26 | $95.50 | $186.21 |
Where North Carolina sits
The same service costs 4.0 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· 11th of 51
$912
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.