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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | None | $30.20 | $30.90 | $30.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $95.50 | Professional | None | $67.61 | $89.13 | $95.50 |
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 $30.90 Median $37.15 Typical High $141.25 | Facility | None | $30.90 | $37.15 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $52.48 | Professional | None | $30.90 | $30.90 | $52.48 |
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 $14.79 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.03 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.47 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.09 | $3.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.49 Median $15.49 Typical High $38.90 | Professional | 51 · Multiple procedures | $15.49 | $15.49 | $38.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $6.17 Typical High $15.85 | Professional | 80 · Assistant surgeon | $6.17 | $6.17 | $15.85 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.27 Median $4.27 Typical High $10.96 | Professional | 81 · Minimal assistant surgeon | $4.27 | $4.27 | $10.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.27 Median $4.27 Typical High $10.96 | Professional | 82 · Assistant surgeon, no resident | $4.27 | $4.27 | $10.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.27 Median $4.27 Typical High $10.96 | Professional | AS · PA/NP assist | $4.27 | $4.27 | $10.96 |
Where North Carolina sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 29th of 51
$89.13
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.