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 $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | None | $23.99 | $23.99 | $26.92 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | None | $25.70 | $25.70 | $28.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $14.13 Median $27.54 Typical High $33.11 | Professional | None | $14.13 | $27.54 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $33.88 | Professional | None | $12.02 | $12.02 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Facility | None | $23.99 | $23.99 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $18.20 Typical High $20.89 | Professional | None | $15.85 | $18.20 | $20.89 |
United Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $30.90 | Professional | None | $14.13 | $19.05 | $30.90 |
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 $12.02 Median $12.02 Typical High $12.88 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | 53 · Discontinued | $4.79 | $4.79 | $5.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.76 Median $8.91 Typical High $10.23 | Professional | 51 · Multiple procedures | $7.76 | $8.91 | $10.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.16 Median $3.63 Typical High $4.17 | Professional | 80 · Assistant surgeon | $3.16 | $3.63 | $4.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.19 Median $2.51 Typical High $2.88 | Professional | 81 · Minimal assistant surgeon | $2.19 | $2.51 | $2.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.19 Median $2.51 Typical High $2.88 | Professional | 82 · Assistant surgeon, no resident | $2.19 | $2.51 | $2.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.19 Median $2.51 Typical High $2.88 | Professional | AS · PA/NP assist | $2.19 | $2.51 | $2.88 |
Where North Carolina sits
The same service costs 2.8 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· 37th of 51
$23.99
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.