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 $177.83 Median $380.19 Typical High $7,413.10 | Facility | None | $177.83 | $380.19 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $389.05 | Professional | None | $177.83 | $281.84 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $1,318.26 | Professional | None | $288.40 | $602.56 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,995.26 | Facility | None | $478.63 | $645.65 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medcost Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $616.60 | Facility | None | $177.83 | $288.40 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $616.60 | Professional | None | $398.11 | $426.58 | $616.60 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $870.96 | Professional | None | $204.17 | $446.68 | $870.96 |
10 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 $89.13 Median $123.03 Typical High $190.55 | Professional | 52 · Reduced service | $89.13 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $75.86 | Professional | 53 · Discontinued | $35.48 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $181.97 Typical High $288.40 | Professional | 54 · Surgery only | $134.90 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | 51 · Multiple procedures | $213.80 | $213.80 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $85.11 Typical High $223.87 | Professional | 80 · Assistant surgeon | $85.11 | $85.11 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $58.88 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $58.88 | $58.88 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $58.88 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $58.88 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $58.88 Typical High $158.49 | Professional | AS · PA/NP assist | $58.88 | $58.88 | $158.49 |
Where North Carolina sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 8th of 51
$490
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.