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 $446.68 Median $446.68 Typical High $7,943.28 | Facility | None | $446.68 | $446.68 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | None | $446.68 | $446.68 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,258.93 | Professional | None | $489.78 | $776.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,174.90 | Professional | None | $524.81 | $602.56 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,819.70 | Facility | None | $446.68 | $537.03 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $724.44 | Professional | None | $512.86 | $562.34 | $724.44 |
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 $398.11 Median $630.96 Typical High $1,096.48 | Professional | None | $398.11 | $630.96 | $1,096.48 |
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 $223.87 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $53.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $281.84 Typical High $645.65 | Professional | 51 · Multiple procedures | $263.03 | $281.84 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $112.20 Typical High $263.03 | Professional | 80 · Assistant surgeon | $104.71 | $112.20 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $79.43 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $72.44 | $79.43 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $79.43 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $79.43 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $79.43 Typical High $181.97 | Professional | AS · PA/NP assist | $72.44 | $79.43 | $181.97 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 26th of 51
$646
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.