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 $20.89 Median $20.89 Typical High $79.43 | Facility | None | $20.89 | $20.89 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $56.23 Typical High $79.43 | Professional | None | $20.89 | $56.23 | $79.43 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.38 Median $70.79 Typical High $89.13 | Professional | None | $17.38 | $70.79 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $41.69 Typical High $51.29 | Professional | None | $17.78 | $41.69 | $51.29 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $89.13 | Facility | None | $20.89 | $20.89 | $89.13 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $67.61 | Professional | None | $47.86 | $63.10 | $67.61 |
United Setting Professional Modifier None Typical Low $13.18 Median $30.20 Typical High $72.44 | Professional | None | $13.18 | $30.20 | $72.44 |
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 $10.23 Median $28.18 Typical High $39.81 | Professional | 52 · Reduced service | $10.23 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $11.22 Typical High $15.85 | Professional | 53 · Discontinued | $4.17 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $8.32 Typical High $12.02 | Professional | 55 · Aftercare only | $3.09 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $5.62 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.04 | $5.62 | $7.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $23.99 Median $31.62 Typical High $33.88 | Professional | 51 · Multiple procedures | $23.99 | $31.62 | $33.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $12.59 Typical High $13.49 | Professional | 80 · Assistant surgeon | $9.55 | $12.59 | $13.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.76 Median $8.91 Typical High $9.33 | Professional | 81 · Minimal assistant surgeon | $6.76 | $8.91 | $9.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.76 Median $8.91 Typical High $9.33 | Professional | 82 · Assistant surgeon, no resident | $6.76 | $8.91 | $9.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $8.91 Typical High $9.33 | Professional | AS · PA/NP assist | $6.76 | $8.91 | $9.33 |
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 4.4 times more in Hawaii 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· 38th of 51
$43.65
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.