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 $19.95 Median $19.95 Typical High $37.15 | Facility | None | $19.95 | $19.95 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $37.15 | Professional | None | $19.95 | $23.99 | $37.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $89.13 | Professional | None | $30.20 | $50.12 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $19.95 Median $37.15 Typical High $44.67 | Facility | None | $19.95 | $37.15 | $44.67 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $37.15 | Professional | None | $25.70 | $35.48 | $37.15 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | None | $39.81 | $39.81 | $41.69 |
United Setting Professional Modifier None Typical Low $19.95 Median $33.11 Typical High $46.77 | Professional | None | $19.95 | $33.11 | $46.77 |
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 $10.00 Median $11.75 Typical High $18.62 | Professional | 52 · Reduced service | $10.00 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.55 Typical High $5.62 | Professional | 55 · Aftercare only | $3.02 | $3.55 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.34 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.00 | $2.34 | $3.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $17.78 Typical High $18.62 | Professional | 51 · Multiple procedures | $12.88 | $17.78 | $18.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.13 Median $7.08 Typical High $7.41 | Professional | 80 · Assistant surgeon | $5.13 | $7.08 | $7.41 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $4.90 Typical High $5.13 | Professional | 81 · Minimal assistant surgeon | $3.63 | $4.90 | $5.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $4.90 Typical High $5.13 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $4.90 | $5.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $4.90 Typical High $5.13 | Professional | AS · PA/NP assist | $3.63 | $4.90 | $5.13 |
Where North Carolina sits
The same service costs 2.6 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· 3rd of 51
$47.86
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.