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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | None | $85.11 | $104.71 | $104.71 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $213.80 | Facility | None | $125.89 | $134.90 | $213.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | None | $89.13 | $89.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $269.15 | Facility | None | $144.54 | $190.55 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $165.96 | Facility | None | $104.71 | $123.03 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $616.60 | Professional | None | $354.81 | $363.08 | $616.60 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $42.66 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $10.47 | $10.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $181.97 Typical High $501.19 | Professional | 51 · Multiple procedures | $181.97 | $181.97 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $72.44 Typical High $199.53 | Professional | 80 · Assistant surgeon | $72.44 | $72.44 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $51.29 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $51.29 | $51.29 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $51.29 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $51.29 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $51.29 Typical High $138.04 | Professional | AS · PA/NP assist | $51.29 | $51.29 | $138.04 |
Where North Carolina sits
The same service costs 26.9 times more in Kansas than in New York. 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· 49th of 51
$100
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.