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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $70.79 | Professional | None | $29.51 | $45.71 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $30.20 | Facility | None | $25.70 | $25.70 | $30.20 |
Medcost Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $77.62 | Professional | None | $19.95 | $26.30 | $77.62 |
United Setting Professional Modifier None Typical Low $22.39 Median $35.48 Typical High $57.54 | Professional | None | $22.39 | $35.48 | $57.54 |
9 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 $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.00 Median $13.18 Typical High $38.90 | Professional | 51 · Multiple procedures | $10.00 | $13.18 | $38.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.98 Median $5.37 Typical High $15.49 | Professional | 80 · Assistant surgeon | $3.98 | $5.37 | $15.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.82 Median $3.72 Typical High $10.96 | Professional | 81 · Minimal assistant surgeon | $2.82 | $3.72 | $10.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.82 Median $3.72 Typical High $10.96 | Professional | 82 · Assistant surgeon, no resident | $2.82 | $3.72 | $10.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.82 Median $3.72 Typical High $10.96 | Professional | AS · PA/NP assist | $2.82 | $3.72 | $10.96 |
Where North Carolina sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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
$31.62
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.