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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | None | $30.20 | $30.20 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | None | $31.62 | $31.62 | $35.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $14.13 Median $33.11 Typical High $39.81 | Professional | None | $14.13 | $33.11 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $42.66 | Professional | None | $12.88 | $12.88 | $42.66 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $39.81 | Facility | None | $30.20 | $30.20 | $39.81 |
Medcost Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $25.12 | Professional | None | $18.20 | $21.38 | $25.12 |
United Setting Professional Modifier None Typical Low $17.38 Median $24.55 Typical High $37.15 | Professional | None | $17.38 | $24.55 | $37.15 |
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 $15.14 Median $15.14 Typical High $16.22 | Professional | 52 · Reduced service | $15.14 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.46 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.91 Median $10.47 Typical High $12.59 | Professional | 51 · Multiple procedures | $8.91 | $10.47 | $12.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.63 Median $4.27 Typical High $5.01 | Professional | 80 · Assistant surgeon | $3.63 | $4.27 | $5.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.51 Median $2.95 Typical High $3.47 | Professional | 81 · Minimal assistant surgeon | $2.51 | $2.95 | $3.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.51 Median $2.95 Typical High $3.47 | Professional | 82 · Assistant surgeon, no resident | $2.51 | $2.95 | $3.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.51 Median $2.95 Typical High $3.47 | Professional | AS · PA/NP assist | $2.51 | $2.95 | $3.47 |
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· 36th of 51
$30.20
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.