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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | None | $346.74 | $407.38 | $407.38 |
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 $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 $489.78 Typical High $891.25 | Facility | None | $141.25 | $489.78 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $954.99 | Professional | None | $281.84 | $281.84 | $954.99 |
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 $173.78 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $40.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $141.25 Typical High $371.54 | Professional | 51 · Multiple procedures | $141.25 | $141.25 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $57.54 Typical High $147.91 | Professional | 80 · Assistant surgeon | $57.54 | $57.54 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $39.81 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $39.81 | $39.81 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $39.81 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $39.81 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $39.81 Typical High $102.33 | Professional | AS · PA/NP assist | $39.81 | $39.81 | $102.33 |
Where North Carolina sits
The same service costs 5.9 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.