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 $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | None | $23.99 | $23.99 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $36.31 Typical High $38.90 | Professional | None | $20.42 | $36.31 | $38.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $74.13 | Professional | None | $21.88 | $33.11 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $69.18 | Professional | None | $27.54 | $30.20 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Facility | None | $23.99 | $23.99 | $26.30 |
Medcost Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $27.54 | Professional | None | $18.20 | $27.54 | $27.54 |
Oscar Health Setting Professional Modifier None Typical Low $22.91 Median $41.69 Typical High $52.48 | Professional | None | $22.91 | $41.69 | $52.48 |
United Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $52.48 | Professional | None | $22.91 | $33.11 | $52.48 |
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 $12.02 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $22.39 Median $38.02 Typical High $38.02 | Professional | 59 · Distinct service | $22.39 | $38.02 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $9.12 Median $13.80 Typical High $13.80 | Professional | 51 · Multiple procedures | $9.12 | $13.80 | $13.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.63 Median $5.50 Typical High $5.50 | Professional | 80 · Assistant surgeon | $3.63 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.57 Median $3.80 Typical High $3.80 | Professional | 81 · Minimal assistant surgeon | $2.57 | $3.80 | $3.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.57 Median $3.80 Typical High $3.80 | Professional | 82 · Assistant surgeon, no resident | $2.57 | $3.80 | $3.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.57 Median $3.80 Typical High $3.80 | Professional | AS · PA/NP assist | $2.57 | $3.80 | $3.80 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska 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· 22nd of 51
$30.90
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.