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 $15.14 Median $56.23 Typical High $5,248.07 | Facility | None | $15.14 | $56.23 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $50.12 Typical High $58.88 | Professional | None | $15.14 | $50.12 | $58.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.88 Median $61.66 Typical High $154.88 | Professional | None | $33.88 | $61.66 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | None | $54.95 | $63.10 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $15.14 Median $44.67 Typical High $74.13 | Facility | None | $15.14 | $44.67 | $74.13 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $56.23 | Professional | None | $38.90 | $39.81 | $56.23 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | None | $19.95 | $19.95 | $20.89 |
United Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $85.11 | Professional | None | $22.39 | $37.15 | $85.11 |
9 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 $7.41 Median $20.89 Typical High $28.18 | Professional | 52 · Reduced service | $7.41 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $8.32 Typical High $11.48 | Professional | 53 · Discontinued | $3.02 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $6.17 Typical High $8.51 | Professional | 55 · Aftercare only | $2.24 | $6.17 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $4.17 Typical High $5.62 | Professional | 56 · Pre-op care only | $1.51 | $4.17 | $5.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $19.95 Typical High $28.18 | Professional | 51 · Multiple procedures | $19.50 | $19.95 | $28.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $8.13 Typical High $11.22 | Professional | 80 · Assistant surgeon | $7.76 | $8.13 | $11.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.50 Median $5.62 Typical High $7.76 | Professional | 81 · Minimal assistant surgeon | $5.50 | $5.62 | $7.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.50 Median $5.62 Typical High $7.76 | Professional | 82 · Assistant surgeon, no resident | $5.50 | $5.62 | $7.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.50 Median $5.62 Typical High $7.76 | Professional | AS · PA/NP assist | $5.50 | $5.62 | $7.76 |
Where North Carolina sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 32nd of 51
$58.88
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.