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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $1,174.90 Typical High $1,174.90 | Professional | None | $446.68 | $1,174.90 | $1,174.90 |
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 $117.49 | Professional | None | $85.11 | $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 $1,412.54 Typical High $1,862.09 | Facility | None | $141.25 | $1,412.54 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
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 $223.87 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $223.87 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $89.13 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $67.61 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $44.67 | $117.49 | $117.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $660.69 Typical High $831.76 | Professional | 51 · Multiple procedures | $602.56 | $660.69 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $263.03 Typical High $331.13 | Professional | 80 · Assistant surgeon | $245.47 | $263.03 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $181.97 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $169.82 | $181.97 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $181.97 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $181.97 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $181.97 Typical High $234.42 | Professional | AS · PA/NP assist | $169.82 | $181.97 | $234.42 |
Where North Carolina sits
The same service costs 10.0 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.