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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $112.20 | Professional | None | $107.15 | $109.65 | $112.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $63.10 Median $134.90 Typical High $346.74 | Professional | None | $63.10 | $134.90 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $257.04 | Professional | None | $109.65 | $141.25 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | None | $141.25 | $173.78 | $173.78 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $123.03 | Facility | None | $109.65 | $109.65 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $138.04 | Professional | None | $85.11 | $114.82 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $245.47 | Professional | None | $109.65 | $199.53 | $245.47 |
United Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $269.15 | Professional | None | $102.33 | $123.03 | $269.15 |
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 $53.70 Median $54.95 Typical High $56.23 | Professional | 52 · Reduced service | $53.70 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $11.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $57.54 Typical High $100.00 | Professional | 51 · Multiple procedures | $42.66 | $57.54 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.98 Median $22.91 Typical High $39.81 | Professional | 80 · Assistant surgeon | $16.98 | $22.91 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.75 Median $16.22 Typical High $27.54 | Professional | 81 · Minimal assistant surgeon | $11.75 | $16.22 | $27.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.75 Median $16.22 Typical High $27.54 | Professional | 82 · Assistant surgeon, no resident | $11.75 | $16.22 | $27.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $16.22 Typical High $27.54 | Professional | AS · PA/NP assist | $11.75 | $16.22 | $27.54 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 28th of 51
$126
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.