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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $158.49 Typical High $158.49 | Professional | None | $52.48 | $158.49 | $158.49 |
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 $190.55 Typical High $1,258.93 | Facility | None | $141.25 | $190.55 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,348.96 | Professional | None | $794.33 | $794.33 | $1,348.96 |
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 $26.30 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $26.30 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $10.72 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $7.94 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.25 | $15.85 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $398.11 Typical High $398.11 | Professional | 51 · Multiple procedures | $117.49 | $398.11 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $158.49 Typical High $158.49 | Professional | 80 · Assistant surgeon | $47.86 | $158.49 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $112.20 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $33.11 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $112.20 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $112.20 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $112.20 Typical High $112.20 | Professional | AS · PA/NP assist | $33.11 | $112.20 | $112.20 |
Where North Carolina sits
The same service costs 18.6 times more in Wyoming 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· 42nd 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.