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 $97.72 Median $97.72 Typical High $114.82 | Facility | None | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
BCBS North Carolina Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $138.04 | Facility | None | $97.72 | $97.72 | $138.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $213.80 | Professional | None | $85.11 | $97.72 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $204.17 | Professional | None | $72.44 | $75.86 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $112.20 | Facility | None | $97.72 | $97.72 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | None | $75.86 | $81.28 | $89.13 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $194.98 | Professional | None | $66.07 | $100.00 | $194.98 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $40.74 Typical High $44.67 | Professional | 51 · Multiple procedures | $38.02 | $40.74 | $44.67 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.14 Median $16.22 Typical High $18.20 | Professional | 80 · Assistant surgeon | $15.14 | $16.22 | $18.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.47 Median $11.48 Typical High $12.59 | Professional | 81 · Minimal assistant surgeon | $10.47 | $11.48 | $12.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.47 Median $11.48 Typical High $12.59 | Professional | 82 · Assistant surgeon, no resident | $10.47 | $11.48 | $12.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.47 Median $11.48 Typical High $12.59 | Professional | AS · PA/NP assist | $10.47 | $11.48 | $12.59 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska 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· 38th of 51
$97.72
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.