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 $18.20 Median $25.70 Typical High $87.10 | Facility | None | $18.20 | $25.70 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $48.98 Typical High $61.66 | Professional | None | $18.20 | $48.98 | $61.66 |
BCBS North Carolina Setting Professional Modifier None Typical Low $15.49 Median $81.28 Typical High $204.17 | Professional | None | $15.49 | $81.28 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $66.07 Typical High $97.72 | Professional | None | $20.89 | $66.07 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $23.99 Typical High $81.28 | Facility | None | $18.20 | $23.99 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $79.43 | Professional | None | $44.67 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $17.78 Median $51.29 Typical High $83.18 | Professional | None | $17.78 | $51.29 | $83.18 |
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 $9.12 Median $24.55 Typical High $30.90 | Professional | 52 · Reduced service | $9.12 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $9.77 Typical High $12.30 | Professional | 53 · Discontinued | $3.63 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $7.41 Typical High $9.33 | Professional | 55 · Aftercare only | $2.75 | $7.41 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $1.82 | $4.90 | $6.17 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $39.81 Typical High $39.81 | Professional | 51 · Multiple procedures | $22.39 | $39.81 | $39.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $15.85 Typical High $15.85 | Professional | 80 · Assistant surgeon | $8.91 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.17 Median $11.22 Typical High $11.22 | Professional | 81 · Minimal assistant surgeon | $6.17 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.17 Median $11.22 Typical High $11.22 | Professional | 82 · Assistant surgeon, no resident | $6.17 | $11.22 | $11.22 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.17 Median $11.22 Typical High $11.22 | Professional | AS · PA/NP assist | $6.17 | $11.22 | $11.22 |
Where North Carolina sits
The same service costs 4.9 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· 7th of 51
$74.13
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.