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 $407.38 | Professional | None | $229.09 | $229.09 | $407.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $933.25 | Professional | None | $426.58 | $691.83 | $933.25 |
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 $288.40 Median $338.84 Typical High $707.95 | Professional | None | $288.40 | $338.84 | $707.95 |
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 $331.13 Typical High $371.54 | Professional | None | $213.80 | $331.13 | $371.54 |
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 $371.54 Typical High $616.60 | Professional | None | $234.42 | $371.54 | $616.60 |
9 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 $131.83 | Professional | 52 · Reduced service | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $162.18 Typical High $331.13 | Professional | 51 · Multiple procedures | $107.15 | $162.18 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $66.07 Typical High $131.83 | Professional | 80 · Assistant surgeon | $42.66 | $66.07 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.20 Median $45.71 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $30.20 | $45.71 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.20 Median $45.71 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $30.20 | $45.71 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $45.71 Typical High $93.33 | Professional | AS · PA/NP assist | $30.20 | $45.71 | $93.33 |
Where North Carolina sits
The same service costs 4.1 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· 5th of 51
$617
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.