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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $109.65 | Professional | None | $87.10 | $93.33 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $707.95 | Professional | None | $346.74 | $524.81 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $295.12 | Facility | None | $93.33 | $93.33 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $151.36 | Professional | None | $89.13 | $89.13 | $151.36 |
United Setting Professional Modifier None Typical Low $75.86 Median $309.03 Typical High $676.08 | Professional | None | $75.86 | $309.03 | $676.08 |
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 $43.65 Median $45.71 Typical High $50.12 | Professional | 52 · Reduced service | $43.65 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $19.95 | Professional | 53 · Discontinued | $17.38 | $18.62 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $44.67 Typical High $114.82 | Professional | 51 · Multiple procedures | $44.67 | $44.67 | $114.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.78 Median $17.78 Typical High $45.71 | Professional | 80 · Assistant surgeon | $17.78 | $17.78 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $12.59 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $12.59 | $12.59 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $12.59 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $12.59 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.59 Median $12.59 Typical High $32.36 | Professional | AS · PA/NP assist | $12.59 | $12.59 | $32.36 |
Where North Carolina sits
The same service costs 7.4 times more in North Carolina than in Rhode Island. 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· 1st of 51
$490
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.