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 $24.55 Median $125.89 Typical High $363.08 | Facility | None | $24.55 | $125.89 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $208.93 Typical High $363.08 | Professional | None | $24.55 | $208.93 | $363.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $426.58 | Professional | None | $32.36 | $47.86 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $316.23 Typical High $630.96 | Professional | None | $26.30 | $316.23 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $38.90 Typical High $588.84 | Facility | None | $24.55 | $38.90 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $275.42 | Professional | None | $60.26 | $60.26 | $275.42 |
United Setting Professional Modifier None Typical Low $20.89 Median $181.97 Typical High $323.59 | Professional | None | $20.89 | $181.97 | $323.59 |
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 $12.30 Median $104.71 Typical High $181.97 | Professional | 52 · Reduced service | $12.30 | $104.71 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $41.69 Typical High $72.44 | Professional | 53 · Discontinued | $4.90 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $31.62 Typical High $54.95 | Professional | 55 · Aftercare only | $3.72 | $31.62 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $20.89 Typical High $36.31 | Professional | 56 · Pre-op care only | $2.45 | $20.89 | $36.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.20 Median $30.20 Typical High $138.04 | Professional | 51 · Multiple procedures | $30.20 | $30.20 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.02 Median $12.02 Typical High $56.23 | Professional | 80 · Assistant surgeon | $12.02 | $12.02 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $8.51 | $8.51 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $8.51 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | AS · PA/NP assist | $8.51 | $8.51 | $38.90 |
Where North Carolina sits
The same service costs 16.2 times more in Hawaii than in Maryland. 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· 42nd of 51
$58.88
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.