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 $125.89 Median $128.82 Typical High $169.82 | Facility | None | $125.89 | $128.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $173.78 | Professional | None | $97.72 | $134.90 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $181.97 | Professional | None | $112.20 | $154.88 | $181.97 |
BCBS North Carolina Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $316.23 | Professional | None | $158.49 | $239.88 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $275.42 | Professional | None | $120.23 | $169.82 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $204.17 | Professional | None | $77.62 | $144.54 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $204.17 | Professional | None | $93.33 | $154.88 | $204.17 |
United Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $245.47 | Professional | None | $112.20 | $141.25 | $245.47 |
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 52 · Reduced service Typical Low $42.66 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $42.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $12.88 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $75.86 Typical High $144.54 | Professional | 51 · Multiple procedures | $38.90 | $75.86 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $30.20 Typical High $58.88 | Professional | 80 · Assistant surgeon | $15.49 | $30.20 | $58.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.72 Median $20.89 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $10.72 | $20.89 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.72 Median $20.89 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $10.72 | $20.89 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $20.89 Typical High $40.74 | Professional | AS · PA/NP assist | $10.72 | $20.89 | $40.74 |
Where North Carolina sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 2nd of 51
$209
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.