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 $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $2,754.23 | Professional | None | $95.50 | $95.50 | $2,754.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $223.87 | Facility | None | $125.89 | $131.83 | $223.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $95.50 | Professional | None | $67.61 | $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 $95.50 Median $141.25 Typical High $4,570.88 | Facility | None | $95.50 | $141.25 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $5,011.87 | Professional | None | $229.09 | $229.09 | $5,011.87 |
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 $47.86 Median $47.86 Typical High $1,380.38 | Professional | 52 · Reduced service | $47.86 | $47.86 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $562.34 | Professional | 53 · Discontinued | $19.05 | $19.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $416.87 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $114.82 Typical High $151.36 | Professional | 51 · Multiple procedures | $89.13 | $114.82 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $45.71 Typical High $60.26 | Professional | 80 · Assistant surgeon | $35.48 | $45.71 | $60.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $31.62 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $24.55 | $31.62 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $31.62 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $31.62 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $31.62 Typical High $42.66 | Professional | AS · PA/NP assist | $24.55 | $31.62 | $42.66 |
Where North Carolina sits
The same service costs 37.2 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
$95.50
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.