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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | None | $93.33 | $112.20 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | None | $107.15 | $144.54 | $144.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $186.21 | Professional | None | $64.57 | $81.28 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $204.17 | Professional | None | $38.90 | $57.54 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $83.18 | Professional | None | $58.88 | $58.88 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $177.83 | Facility | None | $74.13 | $112.20 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $131.83 | Professional | None | $50.12 | $63.10 | $131.83 |
United Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $229.09 | Professional | None | $54.95 | $104.71 | $229.09 |
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 $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $22.39 | $22.39 | $22.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $31.62 Typical High $69.18 | Professional | 51 · Multiple procedures | $25.12 | $31.62 | $69.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.00 Median $12.59 Typical High $28.18 | Professional | 80 · Assistant surgeon | $10.00 | $12.59 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $8.91 Typical High $19.50 | Professional | 81 · Minimal assistant surgeon | $7.08 | $8.91 | $19.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $8.91 Typical High $19.50 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $8.91 | $19.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.08 Median $8.91 Typical High $19.50 | Professional | AS · PA/NP assist | $7.08 | $8.91 | $19.50 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Alabama. 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· 48th of 51
$81.28
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.