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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | None | $38.90 | $44.67 | $44.67 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $141.25 Typical High $208.93 | Facility | None | $125.89 | $141.25 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | None | $85.11 | $89.13 | $97.72 |
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 $44.67 Median $70.79 Typical High $1,258.93 | Facility | None | $44.67 | $70.79 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $1,348.96 | Professional | None | $131.83 | $131.83 | $1,348.96 |
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 $19.50 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $7.94 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.76 Typical High $6.76 | Professional | 55 · Aftercare only | $5.89 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.47 | $4.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $66.07 Typical High $128.82 | Professional | 51 · Multiple procedures | $66.07 | $66.07 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $26.30 Typical High $51.29 | Professional | 80 · Assistant surgeon | $26.30 | $26.30 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $18.62 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $18.62 | $18.62 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $18.62 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $18.62 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $18.62 Typical High $35.48 | Professional | AS · PA/NP assist | $18.62 | $18.62 | $35.48 |
Where North Carolina sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 38th 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.