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 $204.17 Median $204.17 Typical High $7,943.28 | Facility | None | $204.17 | $204.17 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $1,288.25 | Professional | None | $204.17 | $204.17 | $1,288.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $489.78 | Professional | None | $141.25 | $295.12 | $489.78 |
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 $223.87 Median $309.03 Typical High $512.86 | Professional | None | $223.87 | $309.03 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $323.59 | Facility | None | $181.97 | $218.78 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $416.87 | Professional | None | $223.87 | $281.84 | $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 $173.78 Median $251.19 Typical High $489.78 | Professional | None | $173.78 | $251.19 | $489.78 |
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 $151.36 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $26.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $141.25 Typical High $288.40 | Professional | 51 · Multiple procedures | $131.83 | $141.25 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $56.23 Typical High $117.49 | Professional | 80 · Assistant surgeon | $52.48 | $56.23 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $39.81 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $36.31 | $39.81 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $39.81 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $39.81 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $39.81 Typical High $81.28 | Professional | AS · PA/NP assist | $36.31 | $39.81 | $81.28 |
Where North Carolina sits
The same service costs 8.5 times more in New York than in Kentucky. 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· 36th of 51
$295
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.