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 $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $4.17 | Professional | None | $3.80 | $4.17 | $4.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $3.89 | Professional | None | $2.95 | $3.02 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.68 Typical High $7.94 | Facility | None | $4.17 | $4.68 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medcost Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Medcost Setting Professional Modifier None Typical Low $0.34 Median $2.88 Typical High $69.18 | Professional | None | $0.34 | $2.88 | $69.18 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.63 Typical High $6.92 | Professional | None | $1.62 | $2.63 | $6.92 |
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 $1.86 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $1.86 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.76 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.56 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.17 Median $1.45 Typical High $34.67 | Professional | 51 · Multiple procedures | $0.17 | $1.45 | $34.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.07 Median $0.58 Typical High $13.80 | Professional | 80 · Assistant surgeon | $0.07 | $0.58 | $13.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.05 Median $0.40 Typical High $9.77 | Professional | 81 · Minimal assistant surgeon | $0.05 | $0.40 | $9.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.05 Median $0.40 Typical High $9.77 | Professional | 82 · Assistant surgeon, no resident | $0.05 | $0.40 | $9.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.05 Median $0.40 Typical High $9.77 | Professional | AS · PA/NP assist | $0.05 | $0.40 | $9.77 |
Where North Carolina sits
The same service costs 4.6 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· 39th of 51
$3.72
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.