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 $69.18 Median $125.89 Typical High $7,413.10 | Facility | None | $69.18 | $125.89 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $128.82 | Professional | None | $69.18 | $97.72 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $295.12 | Professional | None | $58.88 | $138.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $204.17 | Facility | None | $69.18 | $112.20 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $109.65 | Professional | None | $87.10 | $104.71 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
United Setting Professional Modifier None Typical Low $53.70 Median $112.20 Typical High $177.83 | Professional | None | $53.70 | $112.20 | $177.83 |
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 $34.67 Median $40.74 Typical High $63.10 | Professional | 52 · Reduced service | $34.67 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $25.12 | Professional | 53 · Discontinued | $13.80 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.30 Typical High $19.05 | Professional | 55 · Aftercare only | $10.47 | $12.30 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.92 | $8.32 | $12.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | 51 · Multiple procedures | $43.65 | $52.48 | $52.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 80 · Assistant surgeon | $17.38 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 81 · Minimal assistant surgeon | $12.30 | $14.79 | $14.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 82 · Assistant surgeon, no resident | $12.30 | $14.79 | $14.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | AS · PA/NP assist | $12.30 | $14.79 | $14.79 |
Where North Carolina sits
The same service costs 2.3 times more in Alaska than in Michigan. 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· 22nd of 51
$126
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.