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 $208.93 Median $208.93 Typical High $302.00 | Facility | None | $208.93 | $208.93 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $218.78 | Professional | None | $151.36 | $208.93 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $512.86 | Professional | None | $173.78 | $363.08 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $707.95 | Professional | None | $208.93 | $371.54 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $295.12 | Professional | None | $158.49 | $234.42 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $645.65 | Professional | None | $478.63 | $549.54 | $645.65 |
United Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $457.09 | Professional | None | $151.36 | $213.80 | $457.09 |
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 $100.00 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $39.81 | $41.69 | $43.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 51 · Multiple procedures | $79.43 | $117.49 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $46.77 Typical High $46.77 | Professional | 80 · Assistant surgeon | $31.62 | $46.77 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $33.11 Typical High $33.11 | Professional | 81 · Minimal assistant surgeon | $21.88 | $33.11 | $33.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $33.11 Typical High $33.11 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $33.11 | $33.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $33.11 Typical High $33.11 | Professional | AS · PA/NP assist | $21.88 | $33.11 | $33.11 |
Where North Carolina sits
The same service costs 4.2 times more in New Hampshire 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· 34th of 51
$263
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.