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 $269.15 Median $269.15 Typical High $7,943.28 | Facility | None | $269.15 | $269.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $316.23 | Professional | None | $263.03 | $269.15 | $316.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $741.31 | Professional | None | $257.04 | $524.81 | $741.31 |
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 $323.59 Median $380.19 Typical High $575.44 | Professional | None | $323.59 | $380.19 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $1,202.26 | Facility | None | $269.15 | $323.59 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $524.81 | Professional | None | $323.59 | $346.74 | $524.81 |
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 $269.15 Median $380.19 Typical High $660.69 | Professional | None | $269.15 | $380.19 | $660.69 |
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 $134.90 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $31.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $173.78 Typical High $398.11 | Professional | 51 · Multiple procedures | $173.78 | $173.78 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $69.18 Typical High $158.49 | Professional | 80 · Assistant surgeon | $69.18 | $69.18 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $48.98 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $47.86 | $48.98 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $48.98 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $48.98 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $48.98 Typical High $112.20 | Professional | AS · PA/NP assist | $47.86 | $48.98 | $112.20 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 18th of 51
$427
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.