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 $104.71 Median $104.71 Typical High $173.78 | Facility | None | $104.71 | $104.71 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $177.83 | Professional | None | $100.00 | $104.71 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $194.98 | Professional | None | $83.18 | $83.18 | $194.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | None | $165.96 | $218.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $309.03 | Professional | None | $109.65 | $158.49 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $123.03 | Facility | None | $104.71 | $104.71 | $123.03 |
Medcost Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $302.00 | Professional | None | $128.82 | $177.83 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $316.23 | Professional | None | $107.15 | $162.18 | $316.23 |
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 $52.48 Median $52.48 Typical High $53.70 | Professional | 52 · Reduced service | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | FX · Film X-ray | $75.86 | $85.11 | $85.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $89.13 Typical High $162.18 | Professional | 51 · Multiple procedures | $77.62 | $89.13 | $162.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $35.48 Typical High $64.57 | Professional | 80 · Assistant surgeon | $30.90 | $35.48 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $25.12 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $21.88 | $25.12 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $25.12 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $25.12 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $25.12 Typical High $45.71 | Professional | AS · PA/NP assist | $21.88 | $25.12 | $45.71 |
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
$195
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.