How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $85.11 | Professional | None | $67.61 | $74.13 | $85.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $245.47 | Professional | None | $70.79 | $120.23 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $389.05 | Facility | None | $89.13 | $165.96 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $128.82 | Professional | None | $44.67 | $51.29 | $128.82 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $107.15 | Facility | None | $70.79 | $74.13 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | None | $72.44 | $72.44 | $112.20 |
United Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $165.96 | Professional | None | $52.48 | $87.10 | $165.96 |
9 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 $33.88 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $13.49 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $8.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $36.31 Typical High $79.43 | Professional | 51 · Multiple procedures | $36.31 | $36.31 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $14.45 Typical High $31.62 | Professional | 80 · Assistant surgeon | $14.45 | $14.45 | $31.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $10.23 Typical High $21.88 | Professional | 81 · Minimal assistant surgeon | $10.23 | $10.23 | $21.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $10.23 Typical High $21.88 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $10.23 | $21.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $10.23 Typical High $21.88 | Professional | AS · PA/NP assist | $10.23 | $10.23 | $21.88 |
Where North Carolina sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 34th of 51
$91.20
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.