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 $194.98 Median $194.98 Typical High $7,943.28 | Facility | None | $194.98 | $194.98 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $426.58 | Professional | None | $194.98 | $194.98 | $426.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $489.78 | Professional | None | $151.36 | $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 $208.93 Median $295.12 Typical High $501.19 | Professional | None | $208.93 | $295.12 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $309.03 | Facility | None | $181.97 | $218.78 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $316.23 | Professional | None | $190.55 | $257.04 | $316.23 |
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 $162.18 Median $229.09 Typical High $489.78 | Professional | None | $162.18 | $229.09 | $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 $144.54 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $23.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $131.83 Typical High $269.15 | Professional | 51 · Multiple procedures | $120.23 | $131.83 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $53.70 Typical High $107.15 | Professional | 80 · Assistant surgeon | $47.86 | $53.70 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $37.15 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $33.88 | $37.15 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $37.15 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $37.15 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $37.15 Typical High $74.13 | Professional | AS · PA/NP assist | $33.88 | $37.15 | $74.13 |
Where North Carolina sits
The same service costs 10.5 times more in North Dakota 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· 35th of 51
$288
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.