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 $10.96 Median $10.96 Typical High $27.54 | Facility | None | $10.96 | $10.96 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $15.85 Typical High $22.39 | Professional | None | $8.91 | $15.85 | $22.39 |
BCBS North Carolina Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $14.13 | Professional | None | $8.91 | $11.22 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $25.12 | Professional | None | $12.88 | $14.45 | $25.12 |
Medcost Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $13.49 | Facility | None | $10.96 | $10.96 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $9.77 | Professional | None | $8.91 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $30.20 | Professional | None | $11.22 | $14.13 | $30.20 |
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 $5.50 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $4.90 Typical High $4.90 | Professional | 51 · Multiple procedures | $4.47 | $4.90 | $4.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.78 Median $1.95 Typical High $1.95 | Professional | 80 · Assistant surgeon | $1.78 | $1.95 | $1.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.26 Median $1.35 Typical High $1.35 | Professional | 81 · Minimal assistant surgeon | $1.26 | $1.35 | $1.35 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.26 Median $1.35 Typical High $1.35 | Professional | 82 · Assistant surgeon, no resident | $1.26 | $1.35 | $1.35 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.26 Median $1.35 Typical High $1.35 | Professional | AS · PA/NP assist | $1.26 | $1.35 | $1.35 |
Where North Carolina sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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
$11.22
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.