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 $75.86 Median $338.84 Typical High $338.84 | Facility | None | $75.86 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $338.84 Typical High $338.84 | Professional | None | $107.15 | $338.84 | $338.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $138.04 Median $151.36 Typical High $162.18 | Facility | None | $138.04 | $151.36 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | None | $89.13 | $89.13 | $117.49 |
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 $141.25 Median $407.38 Typical High $616.60 | Facility | None | $141.25 | $407.38 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $660.69 | Professional | None | $165.96 | $165.96 | $660.69 |
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 $53.70 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $53.70 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $21.38 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $15.85 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.72 | $33.88 | $33.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $83.18 Typical High $169.82 | Professional | 51 · Multiple procedures | $83.18 | $83.18 | $169.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $67.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $23.44 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $23.44 | $23.44 | $46.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $23.44 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $23.44 | $46.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $23.44 Typical High $46.77 | Professional | AS · PA/NP assist | $23.44 | $23.44 | $46.77 |
Where North Carolina sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 42nd of 51
$112
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.