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 $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $501.19 | Professional | None | $79.43 | $501.19 | $501.19 |
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 $602.56 Typical High $794.33 | Facility | None | $141.25 | $602.56 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $776.25 | Professional | None | $97.72 | $97.72 | $776.25 |
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 $39.81 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $39.81 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $15.85 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $12.02 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $7.94 | $50.12 | $50.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $48.98 Typical High $794.33 | Professional | 51 · Multiple procedures | $48.98 | $48.98 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $19.50 Typical High $316.23 | Professional | 80 · Assistant surgeon | $19.50 | $19.50 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $13.80 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $13.80 | $13.80 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $13.80 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $13.80 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $13.80 Typical High $223.87 | Professional | AS · PA/NP assist | $13.80 | $13.80 | $223.87 |
Where North Carolina sits
The same service costs 7.2 times more in Hawaii 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· 39th of 51
$97.72
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.