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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
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 $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 $812.83 Typical High $1,380.38 | Facility | None | $141.25 | $812.83 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,479.11 | Professional | None | $602.56 | $602.56 | $1,479.11 |
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 $275.42 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $67.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | 51 · Multiple procedures | $302.00 | $302.00 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $123.03 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $123.03 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $85.11 | $85.11 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $85.11 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | AS · PA/NP assist | $85.11 | $85.11 | $169.82 |
Where North Carolina sits
The same service costs 9.1 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.