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 $229.09 Median $229.09 Typical High $7,943.28 | Facility | None | $229.09 | $229.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $977.24 | Professional | None | $446.68 | $691.83 | $977.24 |
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 $309.03 Median $338.84 Typical High $691.83 | Professional | None | $309.03 | $338.84 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $239.88 Typical High $363.08 | Facility | None | $229.09 | $239.88 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $398.11 | Professional | None | $213.80 | $346.74 | $398.11 |
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 $234.42 Median $380.19 Typical High $616.60 | Professional | None | $234.42 | $380.19 | $616.60 |
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 $114.82 Median $114.82 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $28.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $173.78 Typical High $331.13 | Professional | 51 · Multiple procedures | $107.15 | $173.78 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $69.18 Typical High $131.83 | Professional | 80 · Assistant surgeon | $42.66 | $69.18 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $48.98 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $30.20 | $48.98 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $48.98 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $48.98 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $48.98 Typical High $93.33 | Professional | AS · PA/NP assist | $30.20 | $48.98 | $93.33 |
Where North Carolina sits
The same service costs 4.0 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· 7th of 51
$525
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.