How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.32 Median $0.32 Typical High $1.45 | Facility | None | $0.32 | $0.32 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.36 | Professional | None | $0.32 | $0.32 | $0.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $0.41 Median $0.68 Typical High $0.95 | Professional | None | $0.41 | $0.68 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $0.34 Median $0.47 Typical High $0.87 | Professional | None | $0.34 | $0.47 | $0.87 |
Medcost Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.34 | Facility | None | $0.32 | $0.32 | $0.34 |
Medcost Setting Professional Modifier None Typical Low $0.25 Median $0.41 Typical High $0.41 | Professional | None | $0.25 | $0.41 | $0.41 |
United Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
9 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 $0.16 Median $0.16 Typical High $0.18 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $0.12 Median $0.20 Typical High $0.20 | Professional | 51 · Multiple procedures | $0.12 | $0.20 | $0.20 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.05 Median $0.08 Typical High $0.08 | Professional | 80 · Assistant surgeon | $0.05 | $0.08 | $0.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 81 · Minimal assistant surgeon | $0.04 | $0.06 | $0.06 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 82 · Assistant surgeon, no resident | $0.04 | $0.06 | $0.06 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | AS · PA/NP assist | $0.04 | $0.06 | $0.06 |
Where North Carolina sits
The same service costs 645.7 times more in Oklahoma than in Florida. 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· 15th of 51
$0.63
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.