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 $35.48 Median $100.00 Typical High $1,584.89 | Facility | None | $35.48 | $100.00 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $154.88 | Professional | None | $35.48 | $81.28 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $75.86 Typical High $128.82 | Professional | None | $25.70 | $75.86 | $128.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $50.12 | Facility | None | $35.48 | $35.48 | $50.12 |
BCBS North Carolina Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $169.82 | Professional | None | $41.69 | $87.10 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $83.18 | Professional | None | $29.51 | $39.81 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | None | $74.13 | $74.13 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $60.26 Typical High $117.49 | Facility | None | $35.48 | $60.26 | $117.49 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $104.71 | Professional | None | $45.71 | $63.10 | $104.71 |
Oscar Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $23.99 Median $54.95 Typical High $93.33 | Professional | None | $23.99 | $54.95 | $93.33 |
8 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 54 · Surgery only Typical Low $26.92 Median $38.02 Typical High $74.13 | Professional | 54 · Surgery only | $26.92 | $38.02 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.59 Typical High $14.79 | Professional | 55 · Aftercare only | $5.37 | $7.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.55 | $5.13 | $10.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.91 Median $31.62 Typical High $66.07 | Professional | 51 · Multiple procedures | $22.91 | $31.62 | $66.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.33 Median $12.59 Typical High $26.30 | Professional | 80 · Assistant surgeon | $9.33 | $12.59 | $26.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.46 Median $8.91 Typical High $18.62 | Professional | 81 · Minimal assistant surgeon | $6.46 | $8.91 | $18.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.46 Median $8.91 Typical High $18.62 | Professional | 82 · Assistant surgeon, no resident | $6.46 | $8.91 | $18.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.46 Median $8.91 Typical High $18.62 | Professional | AS · PA/NP assist | $6.46 | $8.91 | $18.62 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 23rd of 51
$77.62
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.