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 $74.13 Median $74.13 Typical High $123.03 | Facility | None | $74.13 | $74.13 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $123.03 | Professional | None | $57.54 | $89.13 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $154.88 | Professional | None | $100.00 | $123.03 | $154.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $100.00 | Professional | None | $45.71 | $64.57 | $100.00 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $144.54 | Facility | None | $72.44 | $74.13 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $112.20 | Professional | None | $69.18 | $85.11 | $112.20 |
Oscar Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $120.23 | Professional | None | $40.74 | $66.07 | $120.23 |
8 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 $37.15 Median $44.67 Typical High $61.66 | Professional | 52 · Reduced service | $37.15 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $12.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $34.67 Median $42.66 Typical High $56.23 | Professional | 51 · Multiple procedures | $34.67 | $42.66 | $56.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.80 Median $17.38 Typical High $22.39 | Professional | 80 · Assistant surgeon | $13.80 | $17.38 | $22.39 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $12.02 Typical High $15.85 | Professional | 81 · Minimal assistant surgeon | $9.55 | $12.02 | $15.85 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $12.02 Typical High $15.85 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $12.02 | $15.85 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.55 Median $12.02 Typical High $15.85 | Professional | AS · PA/NP assist | $9.55 | $12.02 | $15.85 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 51st of 51
$61.66
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.