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 $52.48 Median $83.18 Typical High $5,248.07 | Facility | None | $52.48 | $83.18 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $117.49 | Professional | None | $52.48 | $83.18 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $93.33 Median $190.55 Typical High $302.00 | Professional | None | $93.33 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $2,290.87 | Facility | None | $645.65 | $870.96 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $223.87 | Professional | None | $75.86 | $117.49 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $245.47 | Facility | None | $52.48 | $97.72 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $158.49 | Professional | None | $87.10 | $97.72 | $158.49 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $234.42 | Professional | None | $60.26 | $112.20 | $234.42 |
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 $26.30 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $67.61 | Professional | 54 · Surgery only | $39.81 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $9.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $67.61 Typical High $117.49 | Professional | 51 · Multiple procedures | $43.65 | $67.61 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $26.92 Typical High $46.77 | Professional | 80 · Assistant surgeon | $17.38 | $26.92 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.30 Median $19.05 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $12.30 | $19.05 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.30 Median $19.05 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $12.30 | $19.05 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.30 Median $19.05 Typical High $32.36 | Professional | AS · PA/NP assist | $12.30 | $19.05 | $32.36 |
Where North Carolina sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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
$138
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.