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 $234.42 Median $234.42 Typical High $7,943.28 | Facility | None | $234.42 | $234.42 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | None | $234.42 | $234.42 | $295.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $128.82 Median $331.13 Typical High $549.54 | Professional | None | $128.82 | $331.13 | $549.54 |
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 $263.03 Median $346.74 Typical High $588.84 | Professional | None | $263.03 | $346.74 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $251.19 Typical High $371.54 | Facility | None | $234.42 | $251.19 | $371.54 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $398.11 | Professional | None | $234.42 | $281.84 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $181.97 Median $251.19 Typical High $426.58 | Professional | None | $181.97 | $251.19 | $426.58 |
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 $173.78 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $29.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $158.49 Typical High $316.23 | Professional | 51 · Multiple procedures | $117.49 | $158.49 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $63.10 Typical High $125.89 | Professional | 80 · Assistant surgeon | $46.77 | $63.10 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $43.65 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $33.11 | $43.65 | $89.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $43.65 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $43.65 | $89.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $43.65 Typical High $89.13 | Professional | AS · PA/NP assist | $33.11 | $43.65 | $89.13 |
Where North Carolina sits
The same service costs 8.1 times more in New York than in Missouri. 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· 27th 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.