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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | None | $38.90 | $38.90 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | None | $42.66 | $45.71 | $45.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $24.55 Median $45.71 Typical High $54.95 | Professional | None | $24.55 | $45.71 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $54.95 | Professional | None | $20.89 | $20.89 | $54.95 |
Medcost Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $54.95 | Facility | None | $38.90 | $38.90 | $54.95 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $40.74 | Professional | None | $28.18 | $30.90 | $40.74 |
United Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $48.98 | Professional | None | $23.99 | $30.90 | $48.98 |
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 $19.05 Median $19.05 Typical High $20.89 | Professional | 52 · Reduced service | $19.05 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $8.32 | Professional | 53 · Discontinued | $7.76 | $7.76 | $8.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.13 Median $15.49 Typical High $20.42 | Professional | 51 · Multiple procedures | $14.13 | $15.49 | $20.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.62 Median $6.17 Typical High $8.13 | Professional | 80 · Assistant surgeon | $5.62 | $6.17 | $8.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | 81 · Minimal assistant surgeon | $3.98 | $4.37 | $5.75 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | 82 · Assistant surgeon, no resident | $3.98 | $4.37 | $5.75 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | AS · PA/NP assist | $3.98 | $4.37 | $5.75 |
Where North Carolina sits
The same service costs 2.6 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· 21st of 51
$45.71
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.