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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $208.93 | Facility | None | $125.89 | $131.83 | $208.93 |
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 $1,737.80 Typical High $2,630.27 | Facility | None | $141.25 | $1,737.80 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,348.96 | $2,884.03 |
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 $724.44 Median $724.44 Typical High $977.24 | Professional | 52 · Reduced service | $724.44 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | 53 · Discontinued | $288.40 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $676.08 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $489.78 | $676.08 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $269.15 Typical High $645.65 | Professional | 80 · Assistant surgeon | $194.98 | $269.15 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $186.21 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $138.04 | $186.21 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $186.21 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $186.21 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $186.21 Typical High $457.09 | Professional | AS · PA/NP assist | $138.04 | $186.21 | $457.09 |
Where North Carolina sits
The same service costs 19.5 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
$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.