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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | None | $147.91 | $151.36 | $151.36 |
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 $181.97 Typical High $245.47 | Facility | None | $141.25 | $181.97 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $239.88 | Professional | None | $125.89 | $125.89 | $239.88 |
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 $74.13 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $63.10 Typical High $151.36 | Professional | 51 · Multiple procedures | $63.10 | $63.10 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.12 Typical High $61.66 | Professional | 80 · Assistant surgeon | $25.12 | $25.12 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $17.78 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $17.78 | $17.78 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $17.78 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $17.78 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $17.78 Typical High $42.66 | Professional | AS · PA/NP assist | $17.78 | $17.78 | $42.66 |
Where North Carolina sits
The same service costs 2.4 times more in Alaska than in Kentucky. 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· 50th 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.