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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $109.65 | Professional | None | $69.18 | $69.18 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $114.82 | Professional | None | $64.57 | $87.10 | $114.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $229.09 | Professional | None | $104.71 | $223.87 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $204.17 | Professional | None | $85.11 | $109.65 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $83.18 | Facility | None | $69.18 | $69.18 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $213.80 | Professional | None | $66.07 | $95.50 | $213.80 |
Oscar Health Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $158.49 | Professional | None | $39.81 | $77.62 | $158.49 |
United Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $177.83 | Professional | None | $67.61 | $102.33 | $177.83 |
9 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 $34.67 Median $34.67 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.13 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 51 · Multiple procedures | $64.57 | $64.57 | $64.57 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | Q6 · Substitute physician, paid per time | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $47.86 Typical High $107.15 | Professional | 51 · Multiple procedures | $33.11 | $47.86 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $19.05 Typical High $42.66 | Professional | 80 · Assistant surgeon | $13.49 | $19.05 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $13.49 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $9.33 | $13.49 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $13.49 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $13.49 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $13.49 Typical High $30.20 | Professional | AS · PA/NP assist | $9.33 | $13.49 | $30.20 |
Where North Carolina sits
The same service costs 2.7 times more in Minnesota than in Florida. 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· 26th of 51
$97.72
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.