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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | None | $134.90 | $162.18 | $162.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $213.80 | Facility | None | $125.89 | $131.83 | $213.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | None | $85.11 | $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 $141.25 Median $162.18 Typical High $257.04 | Facility | None | $141.25 | $162.18 | $257.04 |
Medcost Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $302.00 | Professional | None | $141.25 | $204.17 | $302.00 |
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 $67.61 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $26.92 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $16.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $162.18 Typical High $186.21 | Professional | 51 · Multiple procedures | $95.50 | $162.18 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $64.57 Typical High $74.13 | Professional | 80 · Assistant surgeon | $38.02 | $64.57 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $45.71 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $26.30 | $45.71 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $45.71 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $45.71 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $45.71 Typical High $52.48 | Professional | AS · PA/NP assist | $26.30 | $45.71 | $52.48 |
Where North Carolina sits
The same service costs 2.3 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
$97.72
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.