How much rates vary
Facilitymedian $126 · 10th to 90th $123 to $174Professionalmedian $126 · 10th to 90th $89 to $174
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $123.03 Median $125.89 Typical High $173.78 | Facility | None | $123.03 | $125.89 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $173.78 | Professional | None | $123.03 | $131.83 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $177.83 | Facility | None | $125.89 | $125.89 | $177.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $169.82 | Professional | None | $89.13 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $269.15 | Professional | None | $109.65 | $154.88 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $177.83 | Facility | None | $123.03 | $123.03 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $162.18 | Professional | None | $107.15 | $112.20 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $131.83 | Professional | None | $97.72 | $100.00 | $131.83 |
United Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $302.00 | Professional | None | $102.33 | $134.90 | $302.00 |
12 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 $61.66 Median $63.10 Typical High $63.10 | Facility | 52 · Reduced service | $61.66 | $63.10 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $173.78 Median $173.78 Typical High $186.21 | Facility | AF · Specialist physician | $173.78 | $173.78 | $186.21 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $131.83 Median $131.83 Typical High $141.25 | Facility | HO · Master's level | $131.83 | $131.83 | $141.25 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $147.91 Median $147.91 Typical High $158.49 | Facility | TD · Registered nurse | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $56.23 Typical High $79.43 | Professional | 51 · Multiple procedures | $52.48 | $56.23 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $22.39 Typical High $32.36 | Professional | 80 · Assistant surgeon | $21.38 | $22.39 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.79 Median $15.85 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $14.79 | $15.85 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.79 Median $15.85 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $14.79 | $15.85 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $14.79 Median $15.85 Typical High $22.39 | Professional | AS · PA/NP assist | $14.79 | $15.85 | $22.39 |
Where North Carolina sits
The same service costs 2.4 times more in Alaska than in Ohio. 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· 30th of 51
$126
AK $245OH $102
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.