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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | None | $169.82 | $169.82 | $194.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $69.18 Median $323.59 Typical High $512.86 | Professional | None | $69.18 | $323.59 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $346.74 | Professional | None | $173.78 | $181.97 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $190.55 | Facility | None | $169.82 | $169.82 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $128.82 Typical High $169.82 | Professional | None | $66.07 | $128.82 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | None | $69.18 | $69.18 | $74.13 |
United Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $275.42 | Professional | None | $154.88 | $190.55 | $275.42 |
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 $85.11 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $33.88 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $64.57 Typical High $85.11 | Professional | 51 · Multiple procedures | $33.11 | $64.57 | $85.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $25.70 Typical High $33.88 | Professional | 80 · Assistant surgeon | $13.18 | $25.70 | $33.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $17.78 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $9.33 | $17.78 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $17.78 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $17.78 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $17.78 Typical High $23.99 | Professional | AS · PA/NP assist | $9.33 | $17.78 | $23.99 |
Where North Carolina sits
The same service costs 2.9 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
$295
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.