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 $478.63 Median $478.63 Typical High $7,943.28 | Facility | None | $478.63 | $478.63 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | None | $478.63 | $478.63 | $660.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,698.24 | Professional | None | $794.33 | $1,230.27 | $1,698.24 |
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 $630.96 Median $707.95 Typical High $1,479.11 | Professional | None | $630.96 | $707.95 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $758.58 | Facility | None | $478.63 | $501.19 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $812.83 | Professional | None | $457.09 | $707.95 | $812.83 |
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 $489.78 Median $776.25 Typical High $1,288.25 | Professional | None | $489.78 | $776.25 | $1,288.25 |
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 $239.88 Median $239.88 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $60.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $354.81 Typical High $707.95 | Professional | 51 · Multiple procedures | $223.87 | $354.81 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $141.25 Typical High $281.84 | Professional | 80 · Assistant surgeon | $91.20 | $141.25 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $100.00 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $63.10 | $100.00 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $100.00 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $100.00 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $100.00 Typical High $194.98 | Professional | AS · PA/NP assist | $63.10 | $100.00 | $194.98 |
Where North Carolina sits
The same service costs 3.8 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· 13th 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.