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 $891.25 Median $1,148.15 Typical High $1,348.96 | Facility | None | $891.25 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $1,023.29 Typical High $1,348.96 | Professional | None | $54.95 | $1,023.29 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $30.20 Median $1,096.48 Typical High $2,630.27 | Professional | None | $30.20 | $1,096.48 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $1,348.96 Typical High $1,621.81 | Facility | None | $35.48 | $1,348.96 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | None | $758.58 | $1,023.29 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $2,630.27 | Professional | None | $33.11 | $72.44 | $2,630.27 |
United Setting Professional Modifier None Typical Low $24.55 Median $758.58 Typical High $1,318.26 | Professional | None | $24.55 | $758.58 | $1,318.26 |
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 $20.89 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $20.89 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $134.90 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 51 · Multiple procedures | $380.19 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 80 · Assistant surgeon | $154.88 | $208.93 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $107.15 | $144.54 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $144.54 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | AS · PA/NP assist | $107.15 | $144.54 | $144.54 |
Where North Carolina sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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
$1,096
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.