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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | None | $95.50 | $95.50 | $107.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $199.53 | Facility | None | $125.89 | $134.90 | $199.53 |
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 $95.50 Median $123.03 Typical High $151.36 | Facility | None | $95.50 | $123.03 | $151.36 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
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 $47.86 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $47.86 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $21.38 | Professional | 53 · Discontinued | $19.05 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $10.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $31.62 Median $53.70 Typical High $53.70 | Professional | 51 · Multiple procedures | $31.62 | $53.70 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $21.38 Typical High $21.38 | Professional | 80 · Assistant surgeon | $12.59 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.91 Median $14.79 Typical High $14.79 | Professional | 81 · Minimal assistant surgeon | $8.91 | $14.79 | $14.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.91 Median $14.79 Typical High $14.79 | Professional | 82 · Assistant surgeon, no resident | $8.91 | $14.79 | $14.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $14.79 Typical High $14.79 | Professional | AS · PA/NP assist | $8.91 | $14.79 | $14.79 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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
$95.50
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.