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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | None | $138.04 | $165.96 | $165.96 |
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 $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
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 $165.96 Typical High $263.03 | Facility | None | $141.25 | $165.96 | $263.03 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $426.58 | Professional | None | $162.18 | $162.18 | $426.58 |
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 $69.18 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $79.43 Typical High $181.97 | Professional | 51 · Multiple procedures | $79.43 | $79.43 | $181.97 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $32.36 Typical High $72.44 | Professional | 80 · Assistant surgeon | $32.36 | $32.36 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $22.39 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $22.39 | $22.39 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $22.39 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $22.39 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $22.39 Typical High $51.29 | Professional | AS · PA/NP assist | $22.39 | $22.39 | $51.29 |
Where North Carolina sits
The same service costs 2.6 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.