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 $51.29 Median $54.95 Typical High $54.95 | Professional | None | $51.29 | $54.95 | $54.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $45.71 | Professional | None | $41.69 | $43.65 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $57.54 | Facility | None | $54.95 | $54.95 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | None | $37.15 | $53.70 | $53.70 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $25.70 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $25.70 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.23 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.13 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $26.92 Typical High $26.92 | Professional | 51 · Multiple procedures | $18.62 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $10.72 Typical High $10.72 | Professional | 80 · Assistant surgeon | $7.41 | $10.72 | $10.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.25 Median $7.59 Typical High $7.59 | Professional | 81 · Minimal assistant surgeon | $5.25 | $7.59 | $7.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.25 Median $7.59 Typical High $7.59 | Professional | 82 · Assistant surgeon, no resident | $5.25 | $7.59 | $7.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.25 Median $7.59 Typical High $7.59 | Professional | AS · PA/NP assist | $5.25 | $7.59 | $7.59 |
Where North Carolina sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 51st of 51
$43.65
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.