How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | None | $61.66 | $70.79 | $70.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $144.54 | Professional | None | $42.66 | $79.43 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $114.82 | Facility | None | $70.79 | $75.86 | $114.82 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $123.03 | Professional | None | $38.90 | $54.95 | $123.03 |
United Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $100.00 | Professional | None | $67.61 | $70.79 | $100.00 |
8 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 54 · Surgery only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 54 · Surgery only | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.33 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $27.54 Typical High $93.33 | Professional | 51 · Multiple procedures | $19.50 | $27.54 | $93.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $10.96 Typical High $37.15 | Professional | 80 · Assistant surgeon | $7.76 | $10.96 | $37.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $7.76 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $5.37 | $7.76 | $25.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $7.76 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $7.76 | $25.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $7.76 Typical High $25.70 | Professional | AS · PA/NP assist | $5.37 | $7.76 | $25.70 |
Where North Carolina sits
The same service costs 123.0 times more in Alabama than in New Jersey. 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· 33rd of 51
$70.79
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.