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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None (both parts) | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $13.18 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $13.18 | $75.86 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $10.23 | Facility | None | $9.55 | $9.55 | $10.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $16.98 Median $23.99 Typical High $52.48 | Professional | None (both parts) | $16.98 | $23.99 | $52.48 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | None (both parts) | $10.00 | $10.47 | $10.47 |
United Setting Professional Modifier None (both parts) Typical Low $10.00 Median $10.47 Typical High $10.96 | Professional | None (both parts) | $10.00 | $10.47 | $10.96 |
8 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 26 · Professional part Typical Low $9.55 Median $21.38 Typical High $21.38 | Professional | 26 · Professional part | $9.55 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $25.12 Median $36.31 Typical High $79.43 | Professional | 50 · Both sides | $25.12 | $36.31 | $79.43 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.32 Median $12.02 Typical High $26.30 | Professional | 51 · Multiple procedures | $8.32 | $12.02 | $26.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.39 Median $4.79 Typical High $10.47 | Professional | 80 · Assistant surgeon | $3.39 | $4.79 | $10.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.34 Median $3.39 Typical High $7.41 | Professional | 81 · Minimal assistant surgeon | $2.34 | $3.39 | $7.41 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.34 Median $3.39 Typical High $7.41 | Professional | 82 · Assistant surgeon, no resident | $2.34 | $3.39 | $7.41 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.34 Median $3.39 Typical High $7.41 | Professional | AS · PA/NP assist | $2.34 | $3.39 | $7.41 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $14.45 Median $31.62 Typical High $31.62 | Professional | TC · Technical part | $14.45 | $31.62 | $31.62 |
Where North Carolina sits
The same service costs 331.1 times more in New Jersey than in New York. 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· 2nd of 51
$75.86
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.