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 $1,445.44 | Professional | None | $239.88 | $239.88 | $1,445.44 |
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 $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 $288.40 Typical High $3,311.31 | Facility | None | $141.25 | $288.40 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $3,548.13 | Professional | None | $269.15 | $269.15 | $3,548.13 |
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 $724.44 | Professional | 52 · Reduced service | $120.23 | $120.23 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $288.40 | Professional | 53 · Discontinued | $47.86 | $47.86 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $218.78 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $144.54 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $144.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $134.90 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $134.90 | $134.90 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $53.70 Typical High $794.33 | Professional | 80 · Assistant surgeon | $53.70 | $53.70 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $37.15 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $37.15 | $37.15 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $37.15 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $37.15 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $37.15 Typical High $562.34 | Professional | AS · PA/NP assist | $37.15 | $37.15 | $562.34 |
Where North Carolina sits
The same service costs 21.9 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.