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 $93.33 Median $93.33 Typical High $125.89 | Facility | None | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $125.89 | Professional | None | $91.20 | $109.65 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $218.78 | Professional | None | $109.65 | $114.82 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $141.25 | Professional | None | $87.10 | $107.15 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $138.04 | Facility | None | $89.13 | $93.33 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $125.89 | Professional | None | $60.26 | $87.10 | $125.89 |
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 $46.77 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $46.77 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $18.62 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.33 | $10.47 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 51 · Multiple procedures | $69.18 | $69.18 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 80 · Assistant surgeon | $27.54 | $27.54 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | AS · PA/NP assist | $19.50 | $19.50 | $19.50 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 27th of 51
$112
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.