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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $70.79 | Professional | None | $22.39 | $22.39 | $70.79 |
BCBS North Carolina Setting Facility Modifier None Typical Low $13.49 Median $14.79 Typical High $15.85 | Facility | None | $13.49 | $14.79 | $15.85 |
BCBS North Carolina Setting Professional Modifier None Typical Low $22.39 Median $91.20 Typical High $104.71 | Professional | None | $22.39 | $91.20 | $104.71 |
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 $22.39 Median $35.48 Typical High $141.25 | Facility | None | $22.39 | $35.48 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $138.04 | Professional | None | $14.13 | $14.13 | $138.04 |
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 $11.22 Median $11.22 Typical High $35.48 | Professional | 52 · Reduced service | $11.22 | $11.22 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $14.45 | Professional | 53 · Discontinued | $4.47 | $4.47 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $10.72 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $7.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $7.08 Typical High $32.36 | Professional | 51 · Multiple procedures | $7.08 | $7.08 | $32.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.82 Median $2.82 Typical High $12.88 | Professional | 80 · Assistant surgeon | $2.82 | $2.82 | $12.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 81 · Minimal assistant surgeon | $1.95 | $1.95 | $8.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 82 · Assistant surgeon, no resident | $1.95 | $1.95 | $8.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | AS · PA/NP assist | $1.95 | $1.95 | $8.91 |
Where North Carolina sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 26th of 51
$91.20
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.