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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | None | $77.62 | $93.33 | $93.33 |
BCBS Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $87.10 | Professional | None | $66.07 | $67.61 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $177.83 | Facility | None | $93.33 | $104.71 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $100.00 | Facility | None | $93.33 | $93.33 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $8.91 Median $97.72 Typical High $223.87 | Professional | None | $8.91 | $97.72 | $223.87 |
United Setting Professional Modifier None Typical Low $24.55 Median $53.70 Typical High $91.20 | Professional | None | $24.55 | $53.70 | $91.20 |
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 $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.47 Median $48.98 Typical High $141.25 | Professional | 51 · Multiple procedures | $4.47 | $48.98 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.82 Median $19.50 Typical High $56.23 | Professional | 80 · Assistant surgeon | $1.82 | $19.50 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.26 Median $13.80 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $1.26 | $13.80 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.26 Median $13.80 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $1.26 | $13.80 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.26 Median $13.80 Typical High $39.81 | Professional | AS · PA/NP assist | $1.26 | $13.80 | $39.81 |
Where North Carolina sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 29th of 51
$83.18
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.