How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $13.49 Median $13.49 Typical High $15.85 | Facility | None | $13.49 | $13.49 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | None | $13.49 | $13.49 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $25.70 | Professional | None | $10.00 | $15.14 | $25.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $10.72 Median $16.22 Typical High $44.67 | Professional | None | $10.72 | $16.22 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $17.38 Typical High $40.74 | Professional | None | $15.85 | $17.38 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Facility | None | $12.88 | $12.88 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $9.12 Median $13.49 Typical High $13.49 | Professional | None | $9.12 | $13.49 | $13.49 |
Oscar Health Setting Professional Modifier None Typical Low $11.22 Median $20.89 Typical High $25.70 | Professional | None | $11.22 | $20.89 | $25.70 |
United Setting Professional Modifier None Typical Low $13.80 Median $19.50 Typical High $30.90 | Professional | None | $13.80 | $19.50 | $30.90 |
8 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 $6.76 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $10.00 Median $25.70 Typical High $32.36 | Professional | 59 · Distinct service | $10.00 | $25.70 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.57 Median $6.76 Typical High $6.76 | Professional | 51 · Multiple procedures | $4.57 | $6.76 | $6.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.82 Median $2.69 Typical High $2.69 | Professional | 80 · Assistant surgeon | $1.82 | $2.69 | $2.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.26 Median $1.91 Typical High $1.91 | Professional | 81 · Minimal assistant surgeon | $1.26 | $1.91 | $1.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.26 Median $1.91 Typical High $1.91 | Professional | 82 · Assistant surgeon, no resident | $1.26 | $1.91 | $1.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.26 Median $1.91 Typical High $1.91 | Professional | AS · PA/NP assist | $1.26 | $1.91 | $1.91 |
Where North Carolina sits
The same service costs 3.0 times more in Minnesota 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· 31st of 51
$16.22
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.