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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
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 $67.61 Median $89.13 Typical High $95.50 | Professional | None | $67.61 | $89.13 | $95.50 |
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 $66.07 Median $107.15 Typical High $1,819.70 | Facility | None | $66.07 | $107.15 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,949.84 | Professional | None | $489.78 | $489.78 | $1,949.84 |
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 $33.11 Median $33.11 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $17.78 | Professional | 53 · Discontinued | $13.18 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $8.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $245.47 Typical High $245.47 | Professional | 51 · Multiple procedures | $48.98 | $245.47 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $97.72 Typical High $97.72 | Professional | 80 · Assistant surgeon | $19.50 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $69.18 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $13.80 | $69.18 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $69.18 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $69.18 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $69.18 Typical High $69.18 | Professional | AS · PA/NP assist | $13.80 | $69.18 | $69.18 |
Where North Carolina sits
The same service costs 17.4 times more in Wyoming than in Montana. 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
$89.13
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.