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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $44.67 | Professional | None | $17.38 | $17.38 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $20.42 | Facility | None | $18.62 | $18.62 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | None | $12.30 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $17.38 Median $21.88 Typical High $36.31 | Professional | None | $17.38 | $21.88 | $36.31 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $6.46 Typical High $6.46 | Professional | 51 · Multiple procedures | $6.17 | $6.46 | $6.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 80 · Assistant surgeon | $2.51 | $2.57 | $2.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 81 · Minimal assistant surgeon | $1.74 | $1.82 | $1.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $1.82 | $1.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | AS · PA/NP assist | $1.74 | $1.82 | $1.82 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 19th of 51
$18.62
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.