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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $389.05 | Professional | None | $251.19 | $288.40 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | None | $275.42 | $275.42 | $302.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $645.65 | Professional | None | $295.12 | $457.09 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $467.74 | Professional | None | $239.88 | $251.19 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $537.03 | Professional | None | $338.84 | $338.84 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $354.81 | Facility | None | $288.40 | $288.40 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $281.84 | Professional | None | $229.09 | $263.03 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $446.68 | Professional | None | $251.19 | $263.03 | $446.68 |
United Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $446.68 | Professional | None | $218.78 | $239.88 | $446.68 |
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 $134.90 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $134.90 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $54.95 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $44.67 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $29.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $131.83 Typical High $158.49 | Professional | 51 · Multiple procedures | $114.82 | $131.83 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $52.48 Typical High $63.10 | Professional | 80 · Assistant surgeon | $45.71 | $52.48 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $36.31 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $31.62 | $36.31 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $36.31 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $36.31 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $36.31 Typical High $43.65 | Professional | AS · PA/NP assist | $31.62 | $36.31 | $43.65 |
Where North Carolina sits
The same service costs 2.8 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· 14th of 51
$398
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.