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 $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $10.23 Typical High $10.23 | Professional | None | $2.51 | $10.23 | $10.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10.47 Median $10.72 Typical High $18.20 | Facility | None | $10.47 | $10.72 | $18.20 |
BCBS North Carolina Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $15.14 | Professional | None | $12.88 | $13.18 | $15.14 |
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 $10.23 Median $16.22 Typical High $141.25 | Facility | None | $10.23 | $16.22 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $19.95 | Professional | None | $12.30 | $12.30 | $19.95 |
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 $1.26 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $1.26 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $0.50 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.37 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.25 | $1.00 | $1.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $6.17 Typical High $12.59 | Professional | 51 · Multiple procedures | $6.17 | $6.17 | $12.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.51 Median $2.51 Typical High $5.01 | Professional | 80 · Assistant surgeon | $2.51 | $2.51 | $5.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $1.74 Typical High $3.47 | Professional | 81 · Minimal assistant surgeon | $1.74 | $1.74 | $3.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $1.74 Typical High $3.47 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $1.74 | $3.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $1.74 Typical High $3.47 | Professional | AS · PA/NP assist | $1.74 | $1.74 | $3.47 |
Where North Carolina sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 28th of 51
$13.18
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.