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 $31.62 Median $31.62 Typical High $93.33 | Facility | None | $31.62 | $31.62 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $97.72 | Professional | None | $31.62 | $57.54 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $25.70 Median $72.44 Typical High $186.21 | Professional | None | $25.70 | $72.44 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $165.96 | Professional | None | $33.11 | $70.79 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $147.91 | Facility | None | $30.90 | $31.62 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $218.78 | Professional | None | $57.54 | $79.43 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $27.54 Median $61.66 Typical High $138.04 | Professional | None | $27.54 | $61.66 | $138.04 |
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 $15.85 Median $21.38 Typical High $46.77 | Professional | 52 · Reduced service | $15.85 | $21.38 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.71 Typical High $18.62 | Professional | 53 · Discontinued | $6.31 | $8.71 | $18.62 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $120.23 Typical High $331.13 | Professional | 50 · Both sides | $85.11 | $120.23 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $39.81 Typical High $112.20 | Professional | 51 · Multiple procedures | $28.84 | $39.81 | $112.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $15.85 Typical High $44.67 | Professional | 80 · Assistant surgeon | $11.48 | $15.85 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.94 Median $11.22 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $7.94 | $11.22 | $30.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.94 Median $11.22 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $7.94 | $11.22 | $30.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.94 Median $11.22 Typical High $30.90 | Professional | AS · PA/NP assist | $7.94 | $11.22 | $30.90 |
Where North Carolina sits
The same service costs 4.2 times more in Washington than in Maryland. 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· 23rd of 51
$72.44
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.