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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | None | $47.86 | $48.98 | $48.98 |
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 $48.98 Median $63.10 Typical High $141.25 | Facility | None | $48.98 | $63.10 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $77.62 | Professional | None | $53.70 | $53.70 | $77.62 |
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 $23.44 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $23.44 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.55 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.79 | $4.90 | $4.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.92 Median $26.92 Typical High $151.36 | Professional | 51 · Multiple procedures | $26.92 | $26.92 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $10.96 Typical High $61.66 | Professional | 80 · Assistant surgeon | $10.96 | $10.96 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $7.59 | $7.59 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $7.59 | $7.59 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.59 Median $7.59 Typical High $42.66 | Professional | AS · PA/NP assist | $7.59 | $7.59 | $42.66 |
Where North Carolina sits
The same service costs 5.1 times more in North Dakota 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· 45th 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.