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 $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,659.59 | Professional | None | $831.76 | $831.76 | $1,659.59 |
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 $87.10 Median $89.13 Typical High $117.49 | Professional | None | $87.10 | $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 $1,000.00 Typical High $1,698.24 | Facility | None | $141.25 | $1,000.00 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,089.30 | Professional | None | $933.25 | $933.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
10 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 $416.87 Median $416.87 Typical High $812.83 | Professional | 52 · Reduced service | $416.87 | $416.87 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $331.13 | Professional | 53 · Discontinued | $165.96 | $165.96 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $1,230.27 | Professional | 54 · Surgery only | $630.96 | $630.96 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $245.47 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $165.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $467.74 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $363.08 | $467.74 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $186.21 Typical High $512.86 | Professional | 80 · Assistant surgeon | $144.54 | $186.21 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $131.83 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $102.33 | $131.83 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $131.83 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $131.83 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $131.83 Typical High $363.08 | Professional | AS · PA/NP assist | $102.33 | $131.83 | $363.08 |
Where North Carolina sits
The same service costs 15.1 times more in Arkansas 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.