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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | None | $100.00 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $380.19 | Professional | None | $120.23 | $257.04 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $141.25 | Facility | None | $117.49 | $117.49 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | None | $81.28 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $208.93 | Professional | None | $107.15 | $123.03 | $208.93 |
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 $50.12 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $50.12 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $19.95 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $11.75 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 51 · Multiple procedures | $40.74 | $60.26 | $60.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.22 Median $24.55 Typical High $24.55 | Professional | 80 · Assistant surgeon | $16.22 | $24.55 | $24.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $11.22 Median $16.98 Typical High $16.98 | Professional | 81 · Minimal assistant surgeon | $11.22 | $16.98 | $16.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $11.22 Median $16.98 Typical High $16.98 | Professional | 82 · Assistant surgeon, no resident | $11.22 | $16.98 | $16.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $11.22 Median $16.98 Typical High $16.98 | Professional | AS · PA/NP assist | $11.22 | $16.98 | $16.98 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in New York. 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· 2nd of 51
$240
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.