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 $346.74 Median $436.52 Typical High $512.86 | Facility | None | $346.74 | $436.52 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $512.86 | Professional | None | $302.00 | $389.05 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $1,047.13 | Professional | None | $354.81 | $489.78 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $398.11 | Professional | None | $263.03 | $398.11 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $602.56 | Professional | None | $288.40 | $389.05 | $602.56 |
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 $177.83 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $51.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $199.53 Typical High $199.53 | Professional | 51 · Multiple procedures | $131.83 | $199.53 | $199.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $79.43 Typical High $79.43 | Professional | 80 · Assistant surgeon | $52.48 | $79.43 | $79.43 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $37.15 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $56.23 | $56.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | AS · PA/NP assist | $37.15 | $56.23 | $56.23 |
Where North Carolina sits
The same service costs 2.1 times more in Wyoming 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· 14th of 51
$468
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.