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 $457.09 Median $457.09 Typical High $7,943.28 | Facility | None | $457.09 | $457.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | None | $457.09 | $457.09 | $549.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $524.81 | Professional | None | $208.93 | $316.23 | $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 $501.19 Median $676.08 Typical High $1,174.90 | Professional | None | $501.19 | $676.08 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $457.09 Typical High $724.44 | Facility | None | $218.78 | $457.09 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $602.56 | Professional | None | $269.15 | $436.52 | $602.56 |
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 $436.52 Typical High $660.69 | Professional | None | $173.78 | $436.52 | $660.69 |
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 $338.84 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $218.78 Typical High $302.00 | Professional | 51 · Multiple procedures | $131.83 | $218.78 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $87.10 Typical High $123.03 | Professional | 80 · Assistant surgeon | $53.70 | $87.10 | $123.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $60.26 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $37.15 | $60.26 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $60.26 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $60.26 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $60.26 Typical High $85.11 | Professional | AS · PA/NP assist | $37.15 | $60.26 | $85.11 |
Where North Carolina sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 51st of 51
$324
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.