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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $154.88 | Professional | None | $87.10 | $154.88 | $154.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $213.80 | Facility | None | $125.89 | $131.83 | $213.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | None | $85.11 | $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 $154.88 Typical High $245.47 | Facility | None | $141.25 | $154.88 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $251.19 | Professional | None | $151.36 | $151.36 | $251.19 |
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 $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $43.65 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $17.78 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $13.18 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.71 | $15.49 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $75.86 Typical High $144.54 | Professional | 51 · Multiple procedures | $75.86 | $75.86 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $30.20 Typical High $57.54 | Professional | 80 · Assistant surgeon | $30.20 | $30.20 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.89 Median $20.89 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $20.89 | $20.89 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.89 Median $20.89 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $20.89 | $20.89 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $20.89 Typical High $40.74 | Professional | AS · PA/NP assist | $20.89 | $20.89 | $40.74 |
Where North Carolina sits
The same service costs 1.9 times more in Alaska than in New York. 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· 44th of 51
$97.72
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.