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 $380.19 Median $380.19 Typical High $7,943.28 | Facility | None | $380.19 | $380.19 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,096.48 | Professional | None | $416.87 | $691.83 | $1,096.48 |
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 $426.58 Median $446.68 Typical High $758.58 | Professional | None | $426.58 | $446.68 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $724.44 | Facility | None | $446.68 | $724.44 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $602.56 | Professional | None | $354.81 | $489.78 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | None | $407.38 | $407.38 | $416.87 |
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 $331.13 Median $416.87 Typical High $724.44 | Professional | None | $331.13 | $416.87 | $724.44 |
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 $281.84 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $43.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $295.12 Typical High $295.12 | Professional | 51 · Multiple procedures | $177.83 | $295.12 | $295.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $112.20 Typical High $120.23 | Professional | 80 · Assistant surgeon | $70.79 | $112.20 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $79.43 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $50.12 | $79.43 | $83.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $79.43 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $79.43 | $83.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $79.43 Typical High $83.18 | Professional | AS · PA/NP assist | $50.12 | $79.43 | $83.18 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$631
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.