How much rates vary
Facilitymedian $43 · 10th to 90th $23 to $59Professionalmedian $36 · 10th to 90th $18 to $55
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 $23.44 Median $42.66 Typical High $54.95 | Facility | None | $23.44 | $42.66 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $44.67 Typical High $58.88 | Professional | None | $23.44 | $44.67 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $41.69 Typical High $63.10 | Professional | None | $23.44 | $41.69 | $63.10 |
BCBS North Carolina Setting Professional Modifier None Typical Low $17.78 Median $33.11 Typical High $47.86 | Professional | None | $17.78 | $33.11 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $50.12 | Professional | None | $30.20 | $47.86 | $50.12 |
Medcost Setting Facility Modifier None Typical Low $23.44 Median $25.12 Typical High $61.66 | Facility | None | $23.44 | $25.12 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $54.95 | Professional | None | $35.48 | $38.02 | $54.95 |
Oscar Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
United Setting Professional Modifier None Typical Low $25.12 Median $40.74 Typical High $64.57 | Professional | None | $25.12 | $40.74 | $64.57 |
15 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 $11.75 Median $21.38 Typical High $21.38 | Facility | 52 · Reduced service | $11.75 | $21.38 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.79 Median $8.51 Typical High $8.51 | Facility | 53 · Discontinued | $4.79 | $8.51 | $8.51 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $58.88 Median $58.88 Typical High $64.57 | Facility | AF · Specialist physician | $58.88 | $58.88 | $64.57 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $44.67 Median $44.67 Typical High $47.86 | Facility | HO · Master's level | $44.67 | $44.67 | $47.86 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $50.12 Median $50.12 Typical High $54.95 | Facility | TD · Registered nurse | $50.12 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $16.98 Typical High $21.38 | Professional | 52 · Reduced service | $11.75 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.76 Typical High $8.51 | Professional | 53 · Discontinued | $4.79 | $6.76 | $8.51 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | AF · Specialist physician | $57.54 | $58.88 | $64.57 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | HO · Master's level | $42.66 | $44.67 | $47.86 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $48.98 Median $50.12 Typical High $54.95 | Professional | TD · Registered nurse | $48.98 | $50.12 | $54.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $19.05 Typical High $27.54 | Professional | 51 · Multiple procedures | $17.78 | $19.05 | $27.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $7.76 Typical High $10.96 | Professional | 80 · Assistant surgeon | $7.08 | $7.76 | $10.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $5.37 Typical High $7.76 | Professional | 81 · Minimal assistant surgeon | $4.90 | $5.37 | $7.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $5.37 Typical High $7.76 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $5.37 | $7.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $5.37 Typical High $7.76 | Professional | AS · PA/NP assist | $4.90 | $5.37 | $7.76 |
Where North Carolina sits
The same service costs 2.3 times more in Hawaii than in Washington, DC. 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· 37th of 51
$36.31
HI $63.10DC $26.92
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.