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 $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $33.11 | Professional | None | $18.20 | $18.62 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $34.67 | Professional | None | $17.78 | $26.30 | $34.67 |
BCBS North Carolina Setting Professional Modifier None Typical Low $15.49 Median $26.30 Typical High $154.88 | Professional | None | $15.49 | $26.30 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $40.74 Typical High $87.10 | Professional | None | $21.88 | $40.74 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | None | $54.95 | $67.61 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $22.39 | Facility | None | $18.20 | $18.20 | $22.39 |
Medcost Setting Professional Modifier None Typical Low $14.79 Median $38.90 Typical High $53.70 | Professional | None | $14.79 | $38.90 | $53.70 |
Oscar Health Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | None | $20.42 | $20.42 | $24.55 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $63.10 | Professional | None | $17.78 | $26.92 | $63.10 |
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 $9.12 Median $9.33 Typical High $10.00 | Professional | 52 · Reduced service | $9.12 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.98 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.41 Median $26.92 Typical High $27.54 | Professional | 51 · Multiple procedures | $7.41 | $26.92 | $27.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.95 Median $10.72 Typical High $10.96 | Professional | 80 · Assistant surgeon | $2.95 | $10.72 | $10.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.04 Median $7.59 Typical High $7.59 | Professional | 81 · Minimal assistant surgeon | $2.04 | $7.59 | $7.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.04 Median $7.59 Typical High $7.59 | Professional | 82 · Assistant surgeon, no resident | $2.04 | $7.59 | $7.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.04 Median $7.59 Typical High $7.59 | Professional | AS · PA/NP assist | $2.04 | $7.59 | $7.59 |
Where North Carolina sits
The same service costs 2.7 times more in Alaska than in Maryland. 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· 24th of 51
$25.12
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.