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 $87.10 Median $87.10 Typical High $645.65 | Facility | None | $87.10 | $87.10 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | None | $87.10 | $87.10 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $239.88 | Professional | None | $107.15 | $165.96 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $177.83 | Professional | None | $89.13 | $104.71 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | None | $141.25 | $141.25 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $169.82 | Professional | None | $69.18 | $138.04 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
United Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $169.82 | Professional | None | $79.43 | $91.20 | $169.82 |
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 $43.65 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $75.86 Typical High $102.33 | Professional | 51 · Multiple procedures | $34.67 | $75.86 | $102.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.80 Median $30.20 Typical High $41.69 | Professional | 80 · Assistant surgeon | $13.80 | $30.20 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $21.38 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $9.55 | $21.38 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $21.38 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $21.38 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $21.38 Typical High $28.84 | Professional | AS · PA/NP assist | $9.55 | $21.38 | $28.84 |
Where North Carolina sits
The same service costs 3.1 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
$155
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.