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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $223.87 | Facility | None | $125.89 | $131.83 | $223.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | None | $89.13 | $89.13 | $109.65 |
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 $181.97 Typical High $436.52 | Facility | None | $141.25 | $181.97 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $467.74 | Professional | None | $158.49 | $158.49 | $467.74 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $79.43 Typical High $218.78 | Professional | 51 · Multiple procedures | $79.43 | $79.43 | $218.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $31.62 Typical High $87.10 | Professional | 80 · Assistant surgeon | $31.62 | $31.62 | $87.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $22.39 | $22.39 | $61.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $22.39 | $61.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | AS · PA/NP assist | $22.39 | $22.39 | $61.66 |
Where North Carolina sits
The same service costs 2.9 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.