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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | None | $4.79 | $4.79 | $5.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $5.50 Median $8.32 Typical High $37.15 | Professional | None | $5.50 | $8.32 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $56.23 Typical High $436.52 | Professional | None | $25.12 | $56.23 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $6.61 | Facility | None | $4.79 | $4.79 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $16.60 Typical High $30.90 | Professional | None | $3.98 | $16.60 | $30.90 |
United Setting Professional Modifier None Typical Low $4.68 Median $9.33 Typical High $20.42 | Professional | None | $4.68 | $9.33 | $20.42 |
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 $2.40 Median $2.40 Typical High $2.63 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.05 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.00 Median $8.13 Typical High $15.49 | Professional | 51 · Multiple procedures | $2.00 | $8.13 | $15.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.79 Median $3.31 Typical High $6.17 | Professional | 80 · Assistant surgeon | $0.79 | $3.31 | $6.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.56 Median $2.29 Typical High $4.27 | Professional | 81 · Minimal assistant surgeon | $0.56 | $2.29 | $4.27 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.56 Median $2.29 Typical High $4.27 | Professional | 82 · Assistant surgeon, no resident | $0.56 | $2.29 | $4.27 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.56 Median $2.29 Typical High $4.27 | Professional | AS · PA/NP assist | $0.56 | $2.29 | $4.27 |
Where North Carolina sits
The same service costs 3.9 times more in Indiana than in New York. 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· 27th of 51
$8.32
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.