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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | None | $87.10 | $87.10 | $97.72 |
BCBS North Carolina Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $213.80 | Facility | None | $120.23 | $123.03 | $213.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $95.50 | Professional | None | $70.79 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $302.00 | Facility | None | $144.54 | $213.80 | $302.00 |
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 $87.10 Median $190.55 Typical High $229.09 | Facility | None | $87.10 | $190.55 | $229.09 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $275.42 | Professional | None | $75.86 | $75.86 | $275.42 |
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 $43.65 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.77 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $38.02 Typical High $128.82 | Professional | 51 · Multiple procedures | $38.02 | $38.02 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $15.14 Typical High $51.29 | Professional | 80 · Assistant surgeon | $15.14 | $15.14 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.72 Median $10.72 Typical High $36.31 | Professional | 81 · Minimal assistant surgeon | $10.72 | $10.72 | $36.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.72 Median $10.72 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $10.72 | $10.72 | $36.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.72 Median $10.72 Typical High $36.31 | Professional | AS · PA/NP assist | $10.72 | $10.72 | $36.31 |
Where North Carolina sits
The same service costs 2.0 times more in Alaska 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
$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.