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 $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $851.14 | Professional | None | $776.25 | $812.83 | $851.14 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,905.46 | Professional | None | $812.83 | $1,288.25 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,412.54 | Professional | None | $741.31 | $776.25 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Facility | None | $691.83 | $691.83 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | None | $549.54 | $549.54 | $575.44 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,023.29 | Professional | None | $446.68 | $676.08 | $1,023.29 |
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 $389.05 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 51 · Multiple procedures | $323.59 | $398.11 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $89.13 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $112.20 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | AS · PA/NP assist | $89.13 | $112.20 | $112.20 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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
$1,148
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.