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 $354.81 Median $354.81 Typical High $7,943.28 | Facility | None | $354.81 | $354.81 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | None | $354.81 | $354.81 | $446.68 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $524.81 | Professional | None | $229.09 | $380.19 | $524.81 |
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 $389.05 Median $537.03 Typical High $912.01 | Professional | None | $389.05 | $537.03 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $575.44 | Facility | None | $218.78 | $354.81 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $1,202.26 | Professional | None | $269.15 | $478.63 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $173.78 Median $346.74 Typical High $524.81 | Professional | None | $173.78 | $346.74 | $524.81 |
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 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $42.66 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $44.67 | $44.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $239.88 Typical High $602.56 | Professional | 51 · Multiple procedures | $131.83 | $239.88 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $95.50 Typical High $239.88 | Professional | 80 · Assistant surgeon | $53.70 | $95.50 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $66.07 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $37.15 | $66.07 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $66.07 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $66.07 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $66.07 Typical High $169.82 | Professional | AS · PA/NP assist | $37.15 | $66.07 | $169.82 |
Where North Carolina sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 42nd of 51
$380
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.