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 $1,096.48 Median $1,096.48 Typical High $5,248.07 | Facility | None | $1,096.48 | $1,096.48 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,398.83 | $3,235.94 |
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 $1,148.15 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,584.89 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,737.80 | Facility | None | $1,096.48 | $1,174.90 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,548.82 | $1,548.82 |
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 $1,000.00 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,230.27 | $2,089.30 |
8 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 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $138.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | 51 · Multiple procedures | $549.54 | $758.58 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $309.03 Typical High $309.03 | Professional | 80 · Assistant surgeon | $218.78 | $309.03 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $154.88 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $213.80 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | AS · PA/NP assist | $154.88 | $213.80 | $213.80 |
Where North Carolina sits
The same service costs 5.6 times more in Alaska 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· 6th of 51
$2,291
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.