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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | None | $707.95 | $1,000.00 | $1,000.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $208.93 | Facility | None | $125.89 | $134.90 | $208.93 |
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 $1,202.26 Typical High $1,737.80 | Facility | None | $141.25 | $1,202.26 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,862.09 | Professional | None | $794.33 | $794.33 | $1,862.09 |
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 $354.81 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $70.79 | $100.00 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $398.11 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $398.11 | $398.11 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $158.49 Typical High $512.86 | Professional | 80 · Assistant surgeon | $158.49 | $158.49 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $112.20 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $112.20 | $112.20 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $112.20 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $112.20 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $112.20 Typical High $354.81 | Professional | AS · PA/NP assist | $112.20 | $112.20 | $354.81 |
Where North Carolina sits
The same service costs 13.2 times more in Hawaii 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.