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 $40.74 Median $40.74 Typical High $63.10 | Facility | None | $40.74 | $40.74 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $63.10 | Professional | None | $40.74 | $47.86 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
BCBS North Carolina Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $151.36 | Professional | None | $58.88 | $93.33 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | None | $89.13 | $91.20 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $75.86 | Facility | None | $40.74 | $63.10 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $61.66 | Professional | None | $42.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $85.11 | Professional | None | $39.81 | $56.23 | $85.11 |
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 $20.42 Median $23.99 Typical High $31.62 | Professional | 52 · Reduced service | $20.42 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $9.55 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.79 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.07 | $4.79 | $6.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $30.90 Typical High $30.90 | Professional | 51 · Multiple procedures | $21.38 | $30.90 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $12.30 Typical High $12.30 | Professional | 80 · Assistant surgeon | $8.51 | $12.30 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.03 Median $8.51 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $6.03 | $8.51 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.03 Median $8.51 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $6.03 | $8.51 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.03 Median $8.51 Typical High $8.71 | Professional | AS · PA/NP assist | $6.03 | $8.51 | $8.71 |
Where North Carolina sits
The same service costs 2.3 times more in Alaska than in Kentucky. 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· 2nd of 51
$87.10
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.