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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None (both parts) | $371.54 | $371.54 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $660.69 Typical High $933.25 | Facility | None | $616.60 | $660.69 | $933.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $436.52 | $436.52 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $257.04 Median $257.04 Typical High $512.86 | Professional | None (both parts) | $257.04 | $257.04 | $512.86 |
12 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 $186.21 Median $186.21 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $42.66 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 26 · Professional part | $102.33 | $102.33 | $109.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 50 · Both sides | $338.84 | $389.05 | $389.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 51 · Multiple procedures | $112.20 | $128.82 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 80 · Assistant surgeon | $45.71 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | 81 · Minimal assistant surgeon | $31.62 | $36.31 | $36.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $36.31 | $36.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | AS · PA/NP assist | $31.62 | $36.31 | $36.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | TC · Technical part | $154.88 | $154.88 | $165.96 |
Where North Carolina sits
The same service costs 6.5 times more in Minnesota than in Montana. 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· 35th of 51
$437
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.