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 $69.18 Median $69.18 Typical High $114.82 | Facility | None | $69.18 | $69.18 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $107.15 | Professional | None | $61.66 | $69.18 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $128.82 | Professional | None | $53.70 | $53.70 | $128.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $223.87 | Professional | None | $109.65 | $144.54 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $204.17 | Professional | None | $72.44 | $104.71 | $204.17 |
Medcost 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 $69.18 Median $69.18 Typical High $79.43 | Facility | None | $69.18 | $69.18 | $79.43 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $190.55 | Professional | None | $85.11 | $117.49 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $208.93 | Professional | None | $70.79 | $107.15 | $208.93 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | FX · Film X-ray | $48.98 | $56.23 | $56.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $51.29 Median $58.88 Typical High $107.15 | Professional | 51 · Multiple procedures | $51.29 | $58.88 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $23.44 Typical High $42.66 | Professional | 80 · Assistant surgeon | $20.42 | $23.44 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.45 Median $16.60 Typical High $29.51 | Professional | 81 · Minimal assistant surgeon | $14.45 | $16.60 | $29.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.45 Median $16.60 Typical High $29.51 | Professional | 82 · Assistant surgeon, no resident | $14.45 | $16.60 | $29.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.45 Median $16.60 Typical High $29.51 | Professional | AS · PA/NP assist | $14.45 | $16.60 | $29.51 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska 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· 10th of 51
$129
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.