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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $57.54 | Professional | None | $36.31 | $36.31 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | None | $32.36 | $32.36 | $47.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $114.82 | Professional | None | $60.26 | $81.28 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $91.20 | Professional | None | $39.81 | $46.77 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $36.31 Typical High $40.74 | Facility | None | $34.67 | $36.31 | $40.74 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $85.11 | Professional | None | $39.81 | $54.95 | $85.11 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $91.20 | Professional | None | $36.31 | $43.65 | $91.20 |
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 $17.78 Median $17.78 Typical High $19.95 | Professional | 52 · Reduced service | $17.78 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $27.54 Typical High $53.70 | Professional | 51 · Multiple procedures | $19.95 | $27.54 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.94 Median $10.96 Typical High $21.38 | Professional | 80 · Assistant surgeon | $7.94 | $10.96 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.50 Median $7.59 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $5.50 | $7.59 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.50 Median $7.59 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $5.50 | $7.59 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.50 Median $7.59 Typical High $15.14 | Professional | AS · PA/NP assist | $5.50 | $7.59 | $15.14 |
Where North Carolina sits
The same service costs 2.7 times more in Alaska than in New York. 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· 3rd 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.