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 $23.99 Median $27.54 Typical High $57.54 | Facility | None | $23.99 | $27.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $60.26 | Professional | None | $18.20 | $30.90 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $38.02 | Professional | None | $24.55 | $33.88 | $38.02 |
BCBS North Carolina Setting Professional Modifier None Typical Low $16.60 Median $23.44 Typical High $93.33 | Professional | None | $16.60 | $23.44 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $70.79 | Professional | None | $47.86 | $63.10 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $19.95 | Facility | None | $18.20 | $18.20 | $19.95 |
Medcost Setting Professional Modifier None Typical Low $13.80 Median $31.62 Typical High $75.86 | Professional | None | $13.80 | $31.62 | $75.86 |
Oscar Health Setting Professional Modifier None Typical Low $16.98 Median $32.36 Typical High $39.81 | Professional | None | $16.98 | $32.36 | $39.81 |
United Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $61.66 | Professional | None | $21.88 | $37.15 | $61.66 |
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 $9.12 Median $9.12 Typical High $9.55 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.92 Median $15.85 Typical High $37.15 | Professional | 51 · Multiple procedures | $6.92 | $15.85 | $37.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.75 Median $6.31 Typical High $15.14 | Professional | 80 · Assistant surgeon | $2.75 | $6.31 | $15.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.95 Median $4.37 Typical High $10.47 | Professional | 81 · Minimal assistant surgeon | $1.95 | $4.37 | $10.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.95 Median $4.37 Typical High $10.47 | Professional | 82 · Assistant surgeon, no resident | $1.95 | $4.37 | $10.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.95 Median $4.37 Typical High $10.47 | Professional | AS · PA/NP assist | $1.95 | $4.37 | $10.47 |
Where North Carolina sits
The same service costs 3.0 times more in Minnesota than in Pennsylvania. 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· 43rd of 51
$25.12
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.