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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $229.09 | Professional | None | $123.03 | $229.09 | $229.09 |
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 $89.13 Median $89.13 Typical High $117.49 | Professional | None | $89.13 | $89.13 | $117.49 |
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 $275.42 Typical High $363.08 | Facility | None | $141.25 | $275.42 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $316.23 | Professional | None | $251.19 | $251.19 | $316.23 |
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 $61.66 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $61.66 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $24.55 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.30 | $22.91 | $22.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $125.89 Typical High $162.18 | Professional | 51 · Multiple procedures | $102.33 | $125.89 | $162.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $50.12 Typical High $66.07 | Professional | 80 · Assistant surgeon | $40.74 | $50.12 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $34.67 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $28.84 | $34.67 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $34.67 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $34.67 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $34.67 Typical High $45.71 | Professional | AS · PA/NP assist | $28.84 | $34.67 | $45.71 |
Where North Carolina sits
The same service costs 1.9 times more in Wyoming 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
$117
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.