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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $158.49 | Professional | None | $70.79 | $70.79 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $83.18 | Facility | None | $74.13 | $74.13 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | None | $50.12 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $147.91 | Professional | None | $70.79 | $89.13 | $147.91 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $26.92 Typical High $26.92 | Professional | 51 · Multiple procedures | $25.12 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.00 Median $10.72 Typical High $10.72 | Professional | 80 · Assistant surgeon | $10.00 | $10.72 | $10.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 81 · Minimal assistant surgeon | $7.08 | $7.41 | $7.41 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $7.41 | $7.41 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | AS · PA/NP assist | $7.08 | $7.41 | $7.41 |
Where North Carolina sits
The same service costs 2.5 times more in Alaska than in Arizona. 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· 26th of 51
$74.13
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.