How much rates vary
Facilitymedian $35 · 10th to 90th $32 to $48Professionalmedian $37 · 10th to 90th $28 to $47
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 $32.36 Median $32.36 Typical High $46.77 | Facility | None | $32.36 | $32.36 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $46.77 | Professional | None | $32.36 | $38.02 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $40.74 | Professional | None | $28.18 | $37.15 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $40.74 | Professional | None | $23.99 | $38.90 | $40.74 |
Medcost Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $50.12 | Facility | None | $46.77 | $46.77 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $43.65 | Professional | None | $27.54 | $30.20 | $43.65 |
Oscar Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $56.23 | Professional | None | $32.36 | $32.36 | $56.23 |
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 $16.22 Median $16.22 Typical High $16.22 | Facility | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $46.77 Median $46.77 Typical High $50.12 | Facility | AF · Specialist physician | $46.77 | $46.77 | $50.12 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | HO · Master's level | $35.48 | $35.48 | $38.02 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $39.81 Median $39.81 Typical High $42.66 | Facility | TD · Registered nurse | $39.81 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | AF · Specialist physician | $44.67 | $46.77 | $50.12 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | HO · Master's level | $33.88 | $35.48 | $38.02 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $38.02 Median $39.81 Typical High $42.66 | Professional | TD · Registered nurse | $38.02 | $39.81 | $42.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.80 Median $15.14 Typical High $21.88 | Professional | 51 · Multiple procedures | $13.80 | $15.14 | $21.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.50 Median $6.03 Typical High $8.71 | Professional | 80 · Assistant surgeon | $5.50 | $6.03 | $8.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.27 Typical High $6.03 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.27 | $6.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.27 Typical High $6.03 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.27 | $6.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.27 Typical High $6.03 | Professional | AS · PA/NP assist | $3.80 | $4.27 | $6.03 |
Where North Carolina sits
The same service costs 2.1 times more in North Dakota 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· 25th of 51
$37.15
ND $54.95OH $26.30
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.