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 $57.54 Median $72.44 Typical High $72.44 | Facility | None | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | None | $72.44 | $72.44 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | None | $114.82 | $117.49 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $26.92 Median $81.28 Typical High $97.72 | Professional | None | $26.92 | $81.28 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $102.33 | Professional | None | $25.70 | $25.70 | $102.33 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Facility | None | $72.44 | $72.44 | $95.50 |
Medcost Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $61.66 | Professional | None | $33.88 | $42.66 | $61.66 |
United Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $83.18 | Professional | None | $34.67 | $58.88 | $83.18 |
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 $36.31 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $21.38 Typical High $30.90 | Professional | 51 · Multiple procedures | $16.98 | $21.38 | $30.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $8.51 Typical High $12.30 | Professional | 80 · Assistant surgeon | $6.76 | $8.51 | $12.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $5.89 Typical High $8.71 | Professional | 81 · Minimal assistant surgeon | $4.79 | $5.89 | $8.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $5.89 Typical High $8.71 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $5.89 | $8.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $5.89 Typical High $8.71 | Professional | AS · PA/NP assist | $4.79 | $5.89 | $8.71 |
Where North Carolina sits
The same service costs 4.1 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· 32nd of 51
$75.86
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.