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 $177.83 Median $177.83 Typical High $7,943.28 | Facility | None | $177.83 | $177.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | None | $177.83 | $177.83 | $251.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $831.76 | Professional | None | $380.19 | $549.54 | $831.76 |
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 $245.47 Median $269.15 Typical High $549.54 | Professional | None | $245.47 | $269.15 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $288.40 | Facility | None | $177.83 | $186.21 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $309.03 | Professional | None | $169.82 | $275.42 | $309.03 |
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 $181.97 Median $302.00 Typical High $489.78 | Professional | None | $181.97 | $302.00 | $489.78 |
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 $89.13 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $22.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $138.04 Typical High $263.03 | Professional | 51 · Multiple procedures | $85.11 | $138.04 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $54.95 Typical High $104.71 | Professional | 80 · Assistant surgeon | $33.88 | $54.95 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $38.02 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $23.44 | $38.02 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $38.02 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $38.02 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $38.02 Typical High $74.13 | Professional | AS · PA/NP assist | $23.44 | $38.02 | $74.13 |
Where North Carolina sits
The same service costs 4.3 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· 8th of 51
$447
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.