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 $30.20 Median $114.82 Typical High $7,413.10 | Facility | None | $30.20 | $114.82 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $104.71 Typical High $173.78 | Professional | None | $30.20 | $104.71 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $204.17 | Professional | None | $131.83 | $165.96 | $204.17 |
BCBS North Carolina Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $281.84 | Facility | None | $138.04 | $204.17 | $281.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $50.12 Median $218.78 Typical High $346.74 | Professional | None | $50.12 | $218.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $630.96 | Facility | None | $112.20 | $177.83 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $125.89 Typical High $229.09 | Professional | None | $38.02 | $125.89 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $112.20 Median $173.78 Typical High $190.55 | Facility | None | $112.20 | $173.78 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $186.21 | Professional | None | $144.54 | $173.78 | $186.21 |
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 $29.51 Median $100.00 Typical High $229.09 | Professional | None | $29.51 | $100.00 | $229.09 |
7 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 $22.39 Median $72.44 Typical High $87.10 | Professional | 54 · Surgery only | $22.39 | $72.44 | $87.10 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $56.23 Median $87.10 Typical High $141.25 | Facility | 51 · Multiple procedures | $56.23 | $87.10 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $87.10 Typical High $141.25 | Professional | 51 · Multiple procedures | $79.43 | $87.10 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $34.67 Typical High $57.54 | Professional | 80 · Assistant surgeon | $31.62 | $34.67 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $24.55 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $22.39 | $24.55 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $24.55 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $24.55 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $24.55 Typical High $39.81 | Professional | AS · PA/NP assist | $22.39 | $24.55 | $39.81 |
Where North Carolina sits
The same service costs 5.1 times more in Iowa 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· 5th of 51
$166
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.