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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | None | $30.90 | $30.90 | $44.67 |
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 $97.72 | Professional | None | $87.10 | $89.13 | $97.72 |
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 $30.90 Median $48.98 Typical High $141.25 | Facility | None | $30.90 | $48.98 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $72.44 | Professional | None | $12.30 | $12.30 | $72.44 |
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 $15.14 Median $15.14 Typical High $21.88 | Professional | 52 · Reduced service | $15.14 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $8.91 | Professional | 53 · Discontinued | $6.17 | $6.17 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 54 · Surgery only | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $6.17 Typical High $151.36 | Professional | 51 · Multiple procedures | $6.17 | $6.17 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.45 Median $2.45 Typical High $61.66 | Professional | 80 · Assistant surgeon | $2.45 | $2.45 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $1.74 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $1.74 | $1.74 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $1.74 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $1.74 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $1.74 Typical High $42.66 | Professional | AS · PA/NP assist | $1.74 | $1.74 | $42.66 |
Where North Carolina sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 36th 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.