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 $123.03 Median $123.03 Typical High $645.65 | Facility | None | $123.03 | $123.03 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $165.96 | Professional | None | $117.49 | $123.03 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $309.03 | Professional | None | $141.25 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $239.88 | Professional | None | $112.20 | $128.82 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | None | $173.78 | $173.78 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $208.93 | Professional | None | $95.50 | $147.91 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $229.09 | Professional | None | $104.71 | $123.03 | $229.09 |
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 $60.26 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $23.99 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $74.13 Typical High $120.23 | Professional | 51 · Multiple procedures | $47.86 | $74.13 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $29.51 Typical High $47.86 | Professional | 80 · Assistant surgeon | $19.05 | $29.51 | $47.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $20.89 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $13.49 | $20.89 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $20.89 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $20.89 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.49 Median $20.89 Typical High $33.88 | Professional | AS · PA/NP assist | $13.49 | $20.89 | $33.88 |
Where North Carolina sits
The same service costs 3.2 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· 6th of 51
$224
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.