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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | None | $165.96 | $208.93 | $208.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,819.70 | Facility | None | $891.25 | $1,288.25 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $380.19 | Professional | None | $144.54 | $223.87 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $1,737.80 Typical High $2,454.71 | Facility | None | $208.93 | $1,737.80 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $316.23 | Professional | None | $125.89 | $128.82 | $316.23 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $436.52 | Professional | None | $138.04 | $151.36 | $436.52 |
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 $123.03 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $123.03 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $24.55 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $20.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $64.57 Typical High $234.42 | Professional | 51 · Multiple procedures | $63.10 | $64.57 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.70 Typical High $93.33 | Professional | 80 · Assistant surgeon | $25.12 | $25.70 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $17.78 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $17.78 | $17.78 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $17.78 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $17.78 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $17.78 Typical High $66.07 | Professional | AS · PA/NP assist | $17.78 | $17.78 | $66.07 |
Where North Carolina sits
The same service costs 17.8 times more in Texas 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· 29th of 51
$209
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.