How much rates vary
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 $107.15 Median $117.49 Typical High $154.88 | Facility | None | $107.15 | $117.49 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $151.36 | Professional | None | $107.15 | $117.49 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | None | $97.72 | $120.23 | $120.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $138.04 | Professional | None | $83.18 | $107.15 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $134.90 | Professional | None | $83.18 | $120.23 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $117.49 Typical High $154.88 | Facility | None | $107.15 | $117.49 | $154.88 |
Medcost Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $138.04 | Professional | None | $97.72 | $100.00 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | None | $114.82 | $114.82 | $123.03 |
United Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $194.98 | Professional | None | $109.65 | $114.82 | $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 $53.70 Median $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $22.91 | $23.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $50.12 Typical High $69.18 | Professional | 51 · Multiple procedures | $48.98 | $50.12 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $20.42 Typical High $28.18 | Professional | 80 · Assistant surgeon | $19.50 | $20.42 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.80 Median $14.13 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $13.80 | $14.13 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.80 Median $14.13 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $13.80 | $14.13 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.80 Median $14.13 Typical High $19.50 | Professional | AS · PA/NP assist | $13.80 | $14.13 | $19.50 |
Where North Carolina sits
The same service costs 2.3 times more in Alaska 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· 33rd of 51
$112
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.