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 $16.22 Median $17.38 Typical High $77.62 | Facility | None | $16.22 | $17.38 | $77.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | None (both parts) | $15.49 | $16.22 | $16.22 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19.50 Median $27.54 Typical High $42.66 | Facility | None | $19.50 | $27.54 | $42.66 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $12.88 Median $16.60 Typical High $39.81 | Professional | None (both parts) | $12.88 | $16.60 | $39.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $16.60 Median $16.60 Typical High $30.20 | Professional | None (both parts) | $16.60 | $16.60 | $30.20 |
Medcost Setting Facility Modifier None Typical Low $16.22 Median $21.88 Typical High $60.26 | Facility | None | $16.22 | $21.88 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $15.49 Median $26.30 Typical High $26.30 | Professional | None (both parts) | $15.49 | $26.30 | $26.30 |
United Setting Professional Modifier None (both parts) Typical Low $16.60 Median $20.42 Typical High $28.84 | Professional | None (both parts) | $16.60 | $20.42 | $28.84 |
8 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 $13.18 Median $36.31 Typical High $36.31 | Professional | GO · Occupational therapy plan | $13.18 | $36.31 | $36.31 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $7.41 Median $10.47 Typical High $10.96 | Professional | 26 · Professional part | $7.41 | $10.47 | $10.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.76 Median $13.18 Typical High $15.14 | Professional | 51 · Multiple procedures | $7.76 | $13.18 | $15.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.09 Median $5.25 Typical High $6.03 | Professional | 80 · Assistant surgeon | $3.09 | $5.25 | $6.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.14 Median $3.72 Typical High $4.17 | Professional | 81 · Minimal assistant surgeon | $2.14 | $3.72 | $4.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.14 Median $3.72 Typical High $4.17 | Professional | 82 · Assistant surgeon, no resident | $2.14 | $3.72 | $4.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.14 Median $3.72 Typical High $4.17 | Professional | AS · PA/NP assist | $2.14 | $3.72 | $4.17 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $11.22 Median $15.85 Typical High $15.85 | Professional | TC · Technical part | $11.22 | $15.85 | $15.85 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Delaware. 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· 43rd of 51
$16.60
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.