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 $25.70 Median $25.70 Typical High $48.98 | Facility | None | $25.70 | $25.70 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $56.23 | Professional | None | $25.70 | $25.70 | $56.23 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $20.89 Median $33.11 Typical High $102.33 | Professional | None | $20.89 | $33.11 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $151.36 | Facility | None | $25.12 | $50.12 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $47.86 | Professional | None | $12.59 | $16.60 | $47.86 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | None | $45.71 | $45.71 | $64.57 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $38.02 | Facility | None | $25.70 | $25.70 | $38.02 |
Medcost Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $61.66 | Professional | None | $26.92 | $38.90 | $61.66 |
United Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $52.48 | Professional | None | $16.98 | $19.95 | $52.48 |
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 $12.88 Median $12.88 Typical High $15.49 | Professional | 52 · Reduced service | $12.88 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.17 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.17 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $34.67 Median $41.69 Typical High $53.70 | Professional | 59 · Distinct service | $34.67 | $41.69 | $53.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $19.50 Typical High $41.69 | Professional | 51 · Multiple procedures | $13.49 | $19.50 | $41.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $7.76 Typical High $16.60 | Professional | 80 · Assistant surgeon | $5.37 | $7.76 | $16.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $5.50 Typical High $11.75 | Professional | 81 · Minimal assistant surgeon | $3.80 | $5.50 | $11.75 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $5.50 Typical High $11.75 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $5.50 | $11.75 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $5.50 Typical High $11.75 | Professional | AS · PA/NP assist | $3.80 | $5.50 | $11.75 |
Where North Carolina sits
The same service costs 6.0 times more in Alaska than in Nevada. 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· 34th of 51
$31.62
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.