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 $131.83 Median $131.83 Typical High $194.98 | Facility | None | $131.83 | $131.83 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $190.55 | Facility | None | $109.65 | $112.20 | $190.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
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 $131.83 Median $158.49 Typical High $309.03 | Facility | None | $131.83 | $158.49 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $331.13 | Professional | None | $165.96 | $165.96 | $331.13 |
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 $66.07 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $26.30 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $83.18 Typical High $186.21 | Professional | 51 · Multiple procedures | $83.18 | $83.18 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $33.88 Typical High $74.13 | Professional | 80 · Assistant surgeon | $33.88 | $33.88 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $23.44 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $23.44 | $23.44 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $23.44 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $23.44 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $23.44 Typical High $51.29 | Professional | AS · PA/NP assist | $23.44 | $23.44 | $51.29 |
Where North Carolina sits
The same service costs 2.2 times more in Alaska 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
$117
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.