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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $537.03 | Professional | None | $489.78 | $512.86 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,258.93 | Professional | None | $588.84 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $912.01 | Professional | None | $478.63 | $501.19 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $977.24 | Professional | None | $676.08 | $676.08 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Facility | None | $512.86 | $512.86 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $549.54 | Professional | None | $407.38 | $524.81 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $776.25 | Professional | None | $316.23 | $331.13 | $776.25 |
United Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $870.96 | Professional | None | $416.87 | $467.74 | $870.96 |
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 $245.47 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $53.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $263.03 Typical High $295.12 | Professional | 51 · Multiple procedures | $204.17 | $263.03 | $295.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $104.71 Typical High $117.49 | Professional | 80 · Assistant surgeon | $81.28 | $104.71 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $56.23 Median $72.44 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $56.23 | $72.44 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $72.44 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $72.44 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $72.44 Typical High $81.28 | Professional | AS · PA/NP assist | $56.23 | $72.44 | $81.28 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in New York. 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· 10th of 51
$794
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.