How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | None | $100.00 | $102.33 | $102.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $31.62 Median $32.36 Typical High $54.95 | Facility | None | $31.62 | $32.36 | $54.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | None | $107.15 | $114.82 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $302.00 | Facility | None | $144.54 | $213.80 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $102.33 Median $131.83 Typical High $165.96 | Facility | None | $102.33 | $131.83 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $162.18 | Professional | None | $109.65 | $109.65 | $162.18 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $19.95 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $54.95 Typical High $151.36 | Professional | 51 · Multiple procedures | $54.95 | $54.95 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $21.88 Typical High $61.66 | Professional | 80 · Assistant surgeon | $21.88 | $21.88 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.49 Median $15.49 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $15.49 | $15.49 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.49 Median $15.49 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $15.49 | $15.49 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.49 Median $15.49 Typical High $42.66 | Professional | AS · PA/NP assist | $15.49 | $15.49 | $42.66 |
Where North Carolina sits
The same service costs 4.4 times more in North Dakota 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· 34th of 51
$115
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.