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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | None | $69.18 | $89.13 | $89.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $13.80 Median $14.13 Typical High $23.99 | Facility | None | $13.80 | $14.13 | $23.99 |
BCBS North Carolina Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $60.26 | Professional | None | $33.11 | $52.48 | $60.26 |
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 $66.07 Median $107.15 Typical High $144.54 | Facility | None | $66.07 | $107.15 | $144.54 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $81.28 | Professional | None | $35.48 | $35.48 | $81.28 |
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 $33.88 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $10.23 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.92 | $8.91 | $8.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $17.78 Typical High $87.10 | Professional | 51 · Multiple procedures | $17.78 | $17.78 | $87.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $7.08 Typical High $35.48 | Professional | 80 · Assistant surgeon | $7.08 | $7.08 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $5.01 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $5.01 | $5.01 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $5.01 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $5.01 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $5.01 Typical High $24.55 | Professional | AS · PA/NP assist | $5.01 | $5.01 | $24.55 |
Where North Carolina sits
The same service costs 2.7 times more in North Dakota 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
$52.48
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.