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 Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $33.11 | Professional | None | $27.54 | $30.20 | $33.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $100.00 | Professional | None | $32.36 | $48.98 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $31.62 Typical High $169.82 | Professional | None | $12.59 | $31.62 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $58.88 | Professional | None | $28.18 | $28.18 | $58.88 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Facility | None | $28.84 | $28.84 | $38.90 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $23.44 Typical High $28.18 | Professional | None | $14.13 | $23.44 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $75.86 | Professional | None | $32.36 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $50.12 | Professional | None | $20.89 | $28.84 | $50.12 |
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 Facility Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $11.48 Typical High $14.13 | Professional | 51 · Multiple procedures | $7.08 | $11.48 | $14.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.82 Median $4.68 Typical High $5.62 | Professional | 80 · Assistant surgeon | $2.82 | $4.68 | $5.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.95 Median $3.24 Typical High $3.89 | Professional | 81 · Minimal assistant surgeon | $1.95 | $3.24 | $3.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.95 Median $3.24 Typical High $3.89 | Professional | 82 · Assistant surgeon, no resident | $1.95 | $3.24 | $3.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.95 Median $3.24 Typical High $3.89 | Professional | AS · PA/NP assist | $1.95 | $3.24 | $3.89 |
Where North Carolina sits
The same service costs 3.6 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· 17th of 51
$42.66
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.