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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | None | $67.61 | $85.11 | $85.11 |
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 $69.18 Median $89.13 Typical High $95.50 | Professional | None | $69.18 | $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 $85.11 Median $134.90 Typical High $229.09 | Facility | None | $85.11 | $134.90 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $275.42 | Professional | None | $42.66 | $42.66 | $275.42 |
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 $33.88 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.88 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $13.49 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.76 | $8.51 | $8.51 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $21.38 Median $21.38 Typical High $97.72 | Professional | 51 · Multiple procedures | $21.38 | $21.38 | $97.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.51 Median $8.51 Typical High $38.90 | Professional | 80 · Assistant surgeon | $8.51 | $8.51 | $38.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.89 Median $5.89 Typical High $26.92 | Professional | 81 · Minimal assistant surgeon | $5.89 | $5.89 | $26.92 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.89 Median $5.89 Typical High $26.92 | Professional | 82 · Assistant surgeon, no resident | $5.89 | $5.89 | $26.92 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.89 Median $5.89 Typical High $26.92 | Professional | AS · PA/NP assist | $5.89 | $5.89 | $26.92 |
Where North Carolina sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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· 38th 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.