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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $2,089.30 | Professional | None | $263.03 | $263.03 | $2,089.30 |
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 $89.13 Median $89.13 Typical High $117.49 | Professional | None | $89.13 | $89.13 | $117.49 |
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 $141.25 Median $316.23 Typical High $3,630.78 | Facility | None | $141.25 | $316.23 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $3,890.45 | Professional | None | $257.04 | $257.04 | $3,890.45 |
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 $131.83 Median $131.83 Typical High $1,023.29 | Professional | 52 · Reduced service | $131.83 | $131.83 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $416.87 | Professional | 53 · Discontinued | $52.48 | $52.48 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $309.03 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $208.93 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 51 · Multiple procedures | $125.89 | $125.89 | $169.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | 80 · Assistant surgeon | $51.29 | $51.29 | $67.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $35.48 | $35.48 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $35.48 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | AS · PA/NP assist | $35.48 | $35.48 | $47.86 |
Where North Carolina sits
The same service costs 24.0 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
$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.