How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $186.21 Median $186.21 Typical High $7,943.28 | Facility | None | $186.21 | $186.21 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $562.34 | Professional | None | $239.88 | $346.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $19,054.61 Median $26,302.68 Typical High $35,481.34 | Facility | None | $19,054.61 | $26,302.68 | $35,481.34 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $524.81 | Professional | None | $190.55 | $263.03 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $794.33 | Facility | None | $181.97 | $218.78 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $354.81 | Professional | None | $141.25 | $223.87 | $354.81 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $501.19 | Professional | None | $181.97 | $251.19 | $501.19 |
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 $91.20 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 53 · Discontinued | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 54 · Surgery only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $112.20 Typical High $269.15 | Professional | 51 · Multiple procedures | $70.79 | $112.20 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $44.67 Typical High $107.15 | Professional | 80 · Assistant surgeon | $28.18 | $44.67 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $31.62 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $19.95 | $31.62 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $31.62 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $31.62 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $31.62 Typical High $75.86 | Professional | AS · PA/NP assist | $19.95 | $31.62 | $75.86 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in New York. 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· 13th of 51
$347
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.