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 $512.86 | Facility | None | $70.79 | $70.79 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $97.72 | Professional | None | $69.18 | $70.79 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $128.82 | Professional | None | $46.77 | $54.95 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $181.97 | Professional | None | $83.18 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $141.25 | Professional | None | $67.61 | $77.62 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $131.83 | Professional | None | $104.71 | $104.71 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $138.04 | Professional | None | $56.23 | $89.13 | $138.04 |
Oscar Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,445.44 | $2,041.74 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $144.54 | Professional | None | $63.10 | $112.20 | $144.54 |
United Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $134.90 | Professional | None | $61.66 | $72.44 | $134.90 |
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 $35.48 Median $35.48 Typical High $37.15 | Professional | 52 · Reduced service | $35.48 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $44.67 Typical High $75.86 | Professional | 51 · Multiple procedures | $28.18 | $44.67 | $75.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $17.78 Typical High $30.20 | Professional | 80 · Assistant surgeon | $11.22 | $17.78 | $30.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $12.59 Typical High $20.89 | Professional | 81 · Minimal assistant surgeon | $7.76 | $12.59 | $20.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $12.59 Typical High $20.89 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $12.59 | $20.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $12.59 Typical High $20.89 | Professional | AS · PA/NP assist | $7.76 | $12.59 | $20.89 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 9th of 51
$117
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.