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 $10.00 Median $10.47 Typical High $77.62 | Facility | None | $10.00 | $10.47 | $77.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.00 Median $10.00 Typical High $14.45 | Professional | None (both parts) | $10.00 | $10.00 | $14.45 |
BCBS North Carolina Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $16.60 | Facility | None | $11.75 | $11.75 | $16.60 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $8.13 Median $10.47 Typical High $26.92 | Professional | None (both parts) | $8.13 | $10.47 | $26.92 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10.00 Median $11.48 Typical High $20.89 | Professional | None (both parts) | $10.00 | $11.48 | $20.89 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $13.80 Typical High $60.26 | Facility | None | $10.00 | $13.80 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $9.12 Median $16.22 Typical High $19.95 | Professional | None (both parts) | $9.12 | $16.22 | $19.95 |
United Setting Professional Modifier None (both parts) Typical Low $10.47 Median $12.88 Typical High $18.20 | Professional | None (both parts) | $10.47 | $12.88 | $18.20 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | GO · Occupational therapy plan | $8.32 | $8.32 | $8.32 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | GP · Physical therapy plan | $8.32 | $8.32 | $9.77 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.47 Median $6.61 Typical High $7.94 | Professional | 26 · Professional part | $4.47 | $6.61 | $7.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $4.57 Median $8.13 Typical High $10.96 | Professional | 51 · Multiple procedures | $4.57 | $8.13 | $10.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.82 Median $3.31 Typical High $4.37 | Professional | 80 · Assistant surgeon | $1.82 | $3.31 | $4.37 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.29 Median $2.29 Typical High $3.09 | Professional | 81 · Minimal assistant surgeon | $1.29 | $2.29 | $3.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.29 Median $2.29 Typical High $3.09 | Professional | 82 · Assistant surgeon, no resident | $1.29 | $2.29 | $3.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.29 Median $2.29 Typical High $3.09 | Professional | AS · PA/NP assist | $1.29 | $2.29 | $3.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $6.61 Median $9.77 Typical High $12.02 | Professional | TC · Technical part | $6.61 | $9.77 | $12.02 |
Where North Carolina sits
The same service costs 2.4 times more in Alaska than in Missouri. 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· 47th of 51
$10.47
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.