How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $64.57 Median $66.07 Typical High $75.86 | Professional | None | $64.57 | $66.07 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $457.09 | Professional | None | $177.83 | $263.03 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $70.79 | Facility | None | $66.07 | $66.07 | $70.79 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $162.18 | Professional | None | $61.66 | $87.10 | $162.18 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $467.74 | Professional | None | $131.83 | $199.53 | $467.74 |
7 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 $32.36 Median $33.11 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $15.14 | Professional | 53 · Discontinued | $12.88 | $13.49 | $15.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $43.65 Typical High $109.65 | Professional | 51 · Multiple procedures | $30.90 | $43.65 | $109.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $17.78 Typical High $44.67 | Professional | 80 · Assistant surgeon | $12.30 | $17.78 | $44.67 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $12.30 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $8.51 | $12.30 | $30.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $12.30 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $12.30 | $30.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $12.30 Typical High $30.90 | Professional | AS · PA/NP assist | $8.51 | $12.30 | $30.90 |
Where North Carolina sits
The same service costs 4.9 times more in Nebraska than in Florida. 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· 4th of 51
$257
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.