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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $229.09 | Professional | None | $79.43 | $141.25 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $151.36 | Professional | None | $75.86 | $79.43 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | None | $100.00 | $100.00 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Facility | None | $72.44 | $72.44 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $77.62 | Professional | None | $21.88 | $54.95 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $25.12 | Professional | None | $23.44 | $23.44 | $25.12 |
United Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $120.23 | Professional | None | $67.61 | $83.18 | $120.23 |
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 $36.31 Median $36.31 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.96 Median $27.54 Typical High $38.90 | Professional | 51 · Multiple procedures | $10.96 | $27.54 | $38.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.37 Median $10.96 Typical High $15.49 | Professional | 80 · Assistant surgeon | $4.37 | $10.96 | $15.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.09 Median $7.76 Typical High $10.72 | Professional | 81 · Minimal assistant surgeon | $3.09 | $7.76 | $10.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.09 Median $7.76 Typical High $10.72 | Professional | 82 · Assistant surgeon, no resident | $3.09 | $7.76 | $10.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.09 Median $7.76 Typical High $10.72 | Professional | AS · PA/NP assist | $3.09 | $7.76 | $10.72 |
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
$129
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.