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 $1.86 Median $2.04 Typical High $2.57 | Facility | None | $1.86 | $2.04 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $2.04 Typical High $2.51 | Professional | None | $1.86 | $2.04 | $2.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1.66 Median $2.19 Typical High $2.40 | Professional | None | $1.66 | $2.19 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $5.01 Typical High $5.01 | Professional | None | $1.00 | $5.01 | $5.01 |
Medcost Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.63 | Facility | None | $2.51 | $2.51 | $2.63 |
Medcost Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $2.34 | Professional | None | $1.62 | $1.82 | $2.34 |
Oscar Health Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.34 | Professional | None | $2.24 | $2.24 | $2.34 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.24 Typical High $3.16 | Professional | None | $1.95 | $2.24 | $3.16 |
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 $0.95 Median $0.95 Typical High $0.95 | Facility | 52 · Reduced service | $0.95 | $0.95 | $0.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.38 | Facility | 53 · Discontinued | $0.38 | $0.38 | $0.38 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $2.51 Median $2.51 Typical High $2.69 | Facility | AF · Specialist physician | $2.51 | $2.51 | $2.69 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $1.86 Median $1.86 Typical High $2.04 | Facility | HO · Master's level | $1.86 | $1.86 | $2.04 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $2.14 Median $2.14 Typical High $2.29 | Facility | TD · Registered nurse | $2.14 | $2.14 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 52 · Reduced service | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 53 · Discontinued | $0.38 | $0.38 | $0.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.81 Median $0.91 Typical High $1.15 | Professional | 51 · Multiple procedures | $0.81 | $0.91 | $1.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.32 Median $0.37 Typical High $0.46 | Professional | 80 · Assistant surgeon | $0.32 | $0.37 | $0.46 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.23 Median $0.26 Typical High $0.32 | Professional | 81 · Minimal assistant surgeon | $0.23 | $0.26 | $0.32 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.23 Median $0.26 Typical High $0.32 | Professional | 82 · Assistant surgeon, no resident | $0.23 | $0.26 | $0.32 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.23 Median $0.26 Typical High $0.32 | Professional | AS · PA/NP assist | $0.23 | $0.26 | $0.32 |
Where North Carolina sits
The same service costs 2.2 times more in North Dakota 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· 30th of 51
$2.19
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.