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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $85.11 | Professional | None | $31.62 | $31.62 | $85.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $75.86 | Professional | None | $45.71 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $245.47 | Professional | None | $109.65 | $109.65 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Facility | None | $85.11 | $85.11 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $173.78 | Professional | None | $43.65 | $89.13 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | None | $199.53 | $199.53 | $208.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.88 Median $39.81 Typical High $87.10 | Professional | 51 · Multiple procedures | $21.88 | $39.81 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.71 Median $15.85 Typical High $34.67 | Professional | 80 · Assistant surgeon | $8.71 | $15.85 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.17 Median $10.96 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $6.17 | $10.96 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.17 Median $10.96 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $6.17 | $10.96 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.17 Median $10.96 Typical High $24.55 | Professional | AS · PA/NP assist | $6.17 | $10.96 | $24.55 |
Where North Carolina sits
The same service costs 6.6 times more in Illinois than in Missouri. 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· 43rd of 51
$75.86
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.