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 $30.90 Median $30.90 Typical High $97.72 | Facility | None | $30.90 | $30.90 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $97.72 | Professional | None | $30.90 | $69.18 | $97.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $25.70 Median $87.10 Typical High $112.20 | Professional | None | $25.70 | $87.10 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $64.57 | Professional | None | $28.18 | $52.48 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $109.65 | Facility | None | $30.90 | $30.90 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $97.72 | Professional | None | $57.54 | $85.11 | $97.72 |
United Setting Professional Modifier None Typical Low $20.89 Median $33.88 Typical High $89.13 | Professional | None | $20.89 | $33.88 | $89.13 |
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 $15.49 Median $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $15.49 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $6.31 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $10.47 Typical High $14.79 | Professional | 55 · Aftercare only | $4.68 | $10.47 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.09 | $6.92 | $9.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $41.69 Typical High $48.98 | Professional | 51 · Multiple procedures | $28.84 | $41.69 | $48.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $16.98 Typical High $19.50 | Professional | 80 · Assistant surgeon | $11.48 | $16.98 | $19.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $11.75 Typical High $13.80 | Professional | 81 · Minimal assistant surgeon | $8.13 | $11.75 | $13.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $11.75 Typical High $13.80 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $11.75 | $13.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $11.75 Typical High $13.80 | Professional | AS · PA/NP assist | $8.13 | $11.75 | $13.80 |
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 3.5 times more in Hawaii 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· 34th of 51
$57.54
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.