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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $354.81 | Professional | None | $87.10 | $138.04 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $354.81 | Professional | None | $117.49 | $141.25 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $147.91 | Facility | None | $134.90 | $134.90 | $147.91 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | None | $97.72 | $128.82 | $128.82 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $288.40 | Professional | None | $123.03 | $234.42 | $288.40 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $275.42 | Professional | None | $102.33 | $131.83 | $275.42 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 51 · Multiple procedures | $48.98 | $63.10 | $63.10 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $25.70 Typical High $25.70 | Professional | 80 · Assistant surgeon | $19.50 | $25.70 | $25.70 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | 81 · Minimal assistant surgeon | $13.49 | $17.78 | $17.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $17.78 | $17.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.49 Median $17.78 Typical High $17.78 | Professional | AS · PA/NP assist | $13.49 | $17.78 | $17.78 |
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· 36th of 51
$138
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.