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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.95 | Professional | None | $16.60 | $16.60 | $19.95 |
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 $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 $190.55 Typical High $269.15 | Facility | None | $144.54 | $190.55 | $269.15 |
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 $16.60 Median $26.92 Typical High $141.25 | Facility | None | $16.60 | $26.92 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $35.48 | Professional | None | $13.49 | $13.49 | $35.48 |
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 $8.32 Median $8.32 Typical High $10.00 | Professional | 52 · Reduced service | $8.32 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | 53 · Discontinued | $3.39 | $3.39 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.02 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $2.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.76 Median $6.76 Typical High $25.70 | Professional | 51 · Multiple procedures | $6.76 | $6.76 | $25.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.69 Median $2.69 Typical High $10.23 | Professional | 80 · Assistant surgeon | $2.69 | $2.69 | $10.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.91 Median $1.91 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $1.91 | $1.91 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.91 Median $1.91 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $1.91 | $1.91 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.91 Median $1.91 Typical High $7.08 | Professional | AS · PA/NP assist | $1.91 | $1.91 | $7.08 |
Where North Carolina sits
The same service costs 6.3 times more in Massachusetts than in Indiana. 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· 26th 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.