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 $42.66 Median $42.66 Typical High $97.72 | Facility | None | $42.66 | $42.66 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $97.72 | Professional | None | $42.66 | $67.61 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $35.48 Median $85.11 Typical High $109.65 | Professional | None | $35.48 | $85.11 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $79.43 | Professional | None | $36.31 | $61.66 | $79.43 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $107.15 | Facility | None | $41.69 | $42.66 | $107.15 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $107.15 | Professional | None | $72.44 | $89.13 | $107.15 |
United Setting Professional Modifier None Typical Low $27.54 Median $43.65 Typical High $93.33 | Professional | None | $27.54 | $43.65 | $93.33 |
10 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 $21.38 Median $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $21.38 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $8.51 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.47 Typical High $14.45 | Professional | 55 · Aftercare only | $6.46 | $10.47 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.27 | $6.92 | $9.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $44.67 Typical High $53.70 | Professional | 51 · Multiple procedures | $36.31 | $44.67 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $18.20 Typical High $21.38 | Professional | 80 · Assistant surgeon | $14.45 | $18.20 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $12.59 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $10.00 | $12.59 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $12.59 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $12.59 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $12.59 Typical High $15.14 | Professional | AS · PA/NP assist | $10.00 | $12.59 | $15.14 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where North Carolina sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 29th of 51
$70.79
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.