How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $77.62 Median $83.18 Typical High $154.88 | Facility | None | $77.62 | $83.18 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $141.25 | Professional | None | $60.26 | $77.62 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $245.47 | Professional | None | $97.72 | $154.88 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $831.76 | Facility | None | $537.03 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $218.78 | Professional | None | $79.43 | $131.83 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $102.33 | Facility | None | $77.62 | $77.62 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $208.93 | Professional | None | $74.13 | $134.90 | $208.93 |
Oscar Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $245.47 | Professional | None | $74.13 | $114.82 | $245.47 |
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 $38.90 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $15.49 | $16.60 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | FX · Film X-ray | $54.95 | $61.66 | $61.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $81.28 Typical High $128.82 | Professional | 51 · Multiple procedures | $37.15 | $81.28 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $32.36 Typical High $51.29 | Professional | 80 · Assistant surgeon | $14.79 | $32.36 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.23 Median $22.91 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $10.23 | $22.91 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.23 Median $22.91 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $10.23 | $22.91 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.23 Median $22.91 Typical High $35.48 | Professional | AS · PA/NP assist | $10.23 | $22.91 | $35.48 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 18th of 51
$135
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.