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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $199.53 | Professional | None | $97.72 | $199.53 | $199.53 |
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 $95.50 | Professional | None | $85.11 | $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 $141.25 Median $239.88 Typical High $323.59 | Facility | None | $141.25 | $239.88 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $331.13 | Professional | None | $204.17 | $204.17 | $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 $48.98 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $48.98 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $19.50 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $14.79 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.77 | $19.95 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $102.33 Typical High $120.23 | Professional | 51 · Multiple procedures | $74.13 | $102.33 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $40.74 Typical High $47.86 | Professional | 80 · Assistant surgeon | $30.20 | $40.74 | $47.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.89 Median $28.84 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $20.89 | $28.84 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.89 Median $28.84 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $20.89 | $28.84 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $28.84 Typical High $33.88 | Professional | AS · PA/NP assist | $20.89 | $28.84 | $33.88 |
Where North Carolina sits
The same service costs 2.5 times more in Wyoming than in New Jersey. 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· 49th 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.