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 $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $457.09 | Professional | None | $239.88 | $239.88 | $457.09 |
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 $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
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 $288.40 Typical High $1,819.70 | Facility | None | $141.25 | $288.40 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $1,949.84 | Professional | None | $251.19 | $251.19 | $1,949.84 |
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 $120.23 Median $120.23 Typical High $229.09 | Professional | 52 · Reduced service | $120.23 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $93.33 | Professional | 53 · Discontinued | $47.86 | $47.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $69.18 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $45.71 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $45.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 51 · Multiple procedures | $125.89 | $125.89 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | 80 · Assistant surgeon | $50.12 | $50.12 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $34.67 | $34.67 | $46.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $34.67 | $46.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | AS · PA/NP assist | $34.67 | $34.67 | $46.77 |
Where North Carolina sits
The same service costs 12.0 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.