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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $16.98 | Professional | None | $12.88 | $12.88 | $16.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $48.98 | Professional | None | $25.70 | $30.20 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $11.48 Median $12.88 Typical High $16.60 | Facility | None | $11.48 | $12.88 | $16.60 |
Medcost Setting Professional Modifier None Typical Low $8.71 Median $13.80 Typical High $23.44 | Professional | None | $8.71 | $13.80 | $23.44 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $53.70 | Professional | None | $32.36 | $38.02 | $53.70 |
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 52 · Reduced service Typical Low $6.46 Median $6.46 Typical High $8.51 | Professional | 52 · Reduced service | $6.46 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $2.51 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.37 Median $6.92 Typical High $11.75 | Professional | 51 · Multiple procedures | $4.37 | $6.92 | $11.75 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.74 Median $2.82 Typical High $4.68 | Professional | 80 · Assistant surgeon | $1.74 | $2.82 | $4.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.23 Median $1.95 Typical High $3.31 | Professional | 81 · Minimal assistant surgeon | $1.23 | $1.95 | $3.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.23 Median $1.95 Typical High $3.31 | Professional | 82 · Assistant surgeon, no resident | $1.23 | $1.95 | $3.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.23 Median $1.95 Typical High $3.31 | Professional | AS · PA/NP assist | $1.23 | $1.95 | $3.31 |
Where North Carolina sits
The same service costs 14.5 times more in Texas than in West Virginia. 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· 21st of 51
$28.84
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.