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 $33.88 Median $38.02 Typical High $38.02 | Facility | None | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $41.69 | Professional | None | $37.15 | $38.02 | $41.69 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $75.86 | Professional | None | $39.81 | $39.81 | $75.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $21.38 Median $43.65 Typical High $51.29 | Professional | None | $21.38 | $43.65 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $53.70 | Professional | None | $17.78 | $17.78 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Facility | None | $38.02 | $38.02 | $51.29 |
Medcost Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $32.36 | Professional | None | $23.99 | $26.92 | $32.36 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $47.86 | Professional | None | $20.89 | $30.20 | $47.86 |
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 $19.95 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.13 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.02 Median $13.49 Typical High $15.85 | Professional | 51 · Multiple procedures | $12.02 | $13.49 | $15.85 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.79 Median $5.37 Typical High $6.46 | Professional | 80 · Assistant surgeon | $4.79 | $5.37 | $6.46 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.39 Median $3.80 Typical High $4.47 | Professional | 81 · Minimal assistant surgeon | $3.39 | $3.80 | $4.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.39 Median $3.80 Typical High $4.47 | Professional | 82 · Assistant surgeon, no resident | $3.39 | $3.80 | $4.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.39 Median $3.80 Typical High $4.47 | Professional | AS · PA/NP assist | $3.39 | $3.80 | $4.47 |
Where North Carolina sits
The same service costs 2.9 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· 34th of 51
$38.90
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.