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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | None | $28.84 | $28.84 | $33.88 |
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 $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 $28.84 Median $34.67 Typical High $141.25 | Facility | None | $28.84 | $34.67 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $48.98 | Professional | None | $21.88 | $21.88 | $48.98 |
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 $14.45 Median $14.45 Typical High $16.98 | Professional | 52 · Reduced service | $14.45 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.76 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.96 Median $10.96 Typical High $29.51 | Professional | 51 · Multiple procedures | $10.96 | $10.96 | $29.51 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.37 Median $4.37 Typical High $11.75 | Professional | 80 · Assistant surgeon | $4.37 | $4.37 | $11.75 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.02 Median $3.02 Typical High $8.32 | Professional | 81 · Minimal assistant surgeon | $3.02 | $3.02 | $8.32 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.02 Median $3.02 Typical High $8.32 | Professional | 82 · Assistant surgeon, no resident | $3.02 | $3.02 | $8.32 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.02 Median $3.02 Typical High $8.32 | Professional | AS · PA/NP assist | $3.02 | $3.02 | $8.32 |
Where North Carolina sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 30th of 51
$89.13
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.