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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $199.53 | Professional | None | $165.96 | $173.78 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $239.88 | Professional | None | $89.13 | $100.00 | $239.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $707.95 | Professional | None | $354.81 | $457.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $186.21 | Facility | None | $173.78 | $173.78 | $186.21 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $186.21 | Professional | None | $125.89 | $173.78 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | None | $64.57 | $64.57 | $69.18 |
United Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $363.08 | Professional | None | $190.55 | $257.04 | $363.08 |
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 $87.10 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $29.51 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $87.10 Typical High $87.10 | Professional | 51 · Multiple procedures | $63.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $34.67 Typical High $34.67 | Professional | 80 · Assistant surgeon | $25.12 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $23.99 Typical High $23.99 | Professional | 81 · Minimal assistant surgeon | $17.38 | $23.99 | $23.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $23.99 Typical High $23.99 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $23.99 | $23.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $23.99 Typical High $23.99 | Professional | AS · PA/NP assist | $17.38 | $23.99 | $23.99 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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
$447
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.