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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | None | $21.88 | $21.88 | $24.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $70.79 | Professional | None | $23.44 | $32.36 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medcost Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $28.18 | Facility | None | $21.88 | $21.88 | $28.18 |
Medcost Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $45.71 | Professional | None | $12.02 | $16.60 | $45.71 |
United Setting Professional Modifier None Typical Low $14.13 Median $25.70 Typical High $60.26 | Professional | None | $14.13 | $25.70 | $60.26 |
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 $10.96 Median $10.96 Typical High $12.30 | Professional | 52 · Reduced service | $10.96 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.90 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.72 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $8.32 Typical High $31.62 | Professional | 51 · Multiple procedures | $6.03 | $8.32 | $31.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.40 Median $3.31 Typical High $12.59 | Professional | 80 · Assistant surgeon | $2.40 | $3.31 | $12.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.70 Median $2.34 Typical High $8.91 | Professional | 81 · Minimal assistant surgeon | $1.70 | $2.34 | $8.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.70 Median $2.34 Typical High $8.91 | Professional | 82 · Assistant surgeon, no resident | $1.70 | $2.34 | $8.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.70 Median $2.34 Typical High $8.91 | Professional | AS · PA/NP assist | $1.70 | $2.34 | $8.91 |
Where North Carolina sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 18th of 51
$31.62
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.