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 $776.25 Median $776.25 Typical High $1,000.00 | Facility | None | $776.25 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,348.96 | Professional | None | $707.95 | $977.24 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,584.89 | Professional | None | $676.08 | $954.99 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,995.26 | Professional | None | $912.01 | $1,318.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,995.26 Typical High $2,290.87 | Facility | None | $870.96 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,659.59 | Professional | None | $562.34 | $954.99 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $2,238.72 | Facility | None | $794.33 | $1,584.89 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,659.59 | Professional | None | $281.84 | $1,023.29 | $1,659.59 |
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 $616.60 Median $912.01 Typical High $2,137.96 | Professional | None | $616.60 | $912.01 | $2,137.96 |
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 52 · Reduced service Typical Low $389.05 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $512.86 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $141.25 | $512.86 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $204.17 Typical High $467.74 | Professional | 80 · Assistant surgeon | $57.54 | $204.17 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $141.25 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $39.81 | $141.25 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $141.25 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $141.25 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $141.25 Typical High $331.13 | Professional | AS · PA/NP assist | $39.81 | $141.25 | $331.13 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Indiana. 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· 15th of 51
$1,175
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.