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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | None | $102.33 | $102.33 | $114.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $316.23 | Professional | None | $114.82 | $194.98 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $204.17 | Professional | None | $107.15 | $112.20 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $223.87 | Professional | None | $141.25 | $141.25 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Facility | None | $102.33 | $102.33 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $104.71 | Professional | None | $57.54 | $77.62 | $104.71 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
United Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $162.18 | Professional | None | $93.33 | $112.20 | $162.18 |
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 $51.29 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $20.42 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $11.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.84 Median $38.90 Typical High $52.48 | Professional | 51 · Multiple procedures | $28.84 | $38.90 | $52.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $15.49 Typical High $20.89 | Professional | 80 · Assistant surgeon | $11.48 | $15.49 | $20.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.13 Median $10.96 Typical High $14.79 | Professional | 81 · Minimal assistant surgeon | $8.13 | $10.96 | $14.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.13 Median $10.96 Typical High $14.79 | Professional | 82 · Assistant surgeon, no resident | $8.13 | $10.96 | $14.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $10.96 Typical High $14.79 | Professional | AS · PA/NP assist | $8.13 | $10.96 | $14.79 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 11th of 51
$178
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.