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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | None | $47.86 | $54.95 | $54.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $177.83 | Professional | None | $56.23 | $117.49 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Facility | None | $54.95 | $54.95 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $56.23 | Professional | None | $38.02 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $97.72 | Professional | None | $50.12 | $57.54 | $97.72 |
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 $23.44 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $9.55 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $28.18 Typical High $28.18 | Professional | 51 · Multiple procedures | $19.05 | $28.18 | $28.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $11.22 Typical High $11.22 | Professional | 80 · Assistant surgeon | $7.59 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $7.94 Typical High $7.94 | Professional | 81 · Minimal assistant surgeon | $5.37 | $7.94 | $7.94 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $7.94 Typical High $7.94 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $7.94 | $7.94 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $7.94 Typical High $7.94 | Professional | AS · PA/NP assist | $5.37 | $7.94 | $7.94 |
Where North Carolina sits
The same service costs 3.1 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
$112
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.