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 $41.69 Median $53.70 Typical High $53.70 | Facility | None | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $54.95 | Professional | None | $38.02 | $53.70 | $54.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $87.10 | Professional | None | $79.43 | $81.28 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $120.23 Typical High $199.53 | Facility | None | $104.71 | $120.23 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Facility | None | $53.70 | $53.70 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $54.95 | Professional | None | $38.02 | $40.74 | $54.95 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
7 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 55 · Aftercare only Typical Low $5.75 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $5.75 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.80 | $5.37 | $5.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $20.42 Typical High $69.18 | Professional | 51 · Multiple procedures | $18.62 | $20.42 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $8.13 Typical High $27.54 | Professional | 80 · Assistant surgeon | $7.41 | $8.13 | $27.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.13 Median $5.75 Typical High $19.05 | Professional | 81 · Minimal assistant surgeon | $5.13 | $5.75 | $19.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.13 Median $5.75 Typical High $19.05 | Professional | 82 · Assistant surgeon, no resident | $5.13 | $5.75 | $19.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.13 Median $5.75 Typical High $19.05 | Professional | AS · PA/NP assist | $5.13 | $5.75 | $19.05 |
Where North Carolina sits
The same service costs 2.6 times more in Texas than in Connecticut. 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· 7th of 51
$81.28
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.