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 $46.77 Median $46.77 Typical High $77.62 | Facility | None | $46.77 | $46.77 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $77.62 | Professional | None | $46.77 | $61.66 | $77.62 |
BCBS North Carolina Setting Facility Modifier None Typical Low $7.24 Median $11.22 Typical High $28.84 | Facility | None | $7.24 | $11.22 | $28.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $190.55 | Professional | None | $70.79 | $114.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $63.10 Typical High $120.23 | Facility | None | $44.67 | $63.10 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $151.36 | Professional | None | $58.88 | $95.50 | $151.36 |
Medcost Setting Facility Modifier None Typical Low $5.50 Median $7.94 Typical High $93.33 | Facility | None | $5.50 | $7.94 | $93.33 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $131.83 | Professional | None | $74.13 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $158.49 | Professional | None | $47.86 | $75.86 | $158.49 |
10 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 52 · Reduced service Typical Low $23.44 Median $30.90 Typical High $38.02 | Professional | 52 · Reduced service | $23.44 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.30 Typical High $15.49 | Professional | 53 · Discontinued | $9.33 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.33 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $9.33 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.68 | $6.17 | $7.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $3.98 Median $3.98 Typical High $39.81 | Facility | 51 · Multiple procedures | $3.98 | $3.98 | $39.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $56.23 Typical High $100.00 | Professional | 51 · Multiple procedures | $37.15 | $56.23 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $22.39 Typical High $39.81 | Professional | 80 · Assistant surgeon | $14.79 | $22.39 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $15.85 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $10.23 | $15.85 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $15.85 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $15.85 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $15.85 Typical High $27.54 | Professional | AS · PA/NP assist | $10.23 | $15.85 | $27.54 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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· 8th of 51
$107
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.