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 $11.75 Median $14.13 Typical High $30.20 | Facility | None | $11.75 | $14.13 | $30.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.00 Median $11.75 Typical High $14.45 | Professional | None (both parts) | $10.00 | $11.75 | $14.45 |
BCBS North Carolina Setting Facility Modifier None Typical Low $14.13 Median $14.45 Typical High $19.95 | Facility | None | $14.13 | $14.45 | $19.95 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $8.91 Median $10.96 Typical High $18.20 | Professional | None (both parts) | $8.91 | $10.96 | $18.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $9.33 Median $10.00 Typical High $20.42 | Professional | None (both parts) | $9.33 | $10.00 | $20.42 |
Medcost Setting Facility Modifier None Typical Low $11.75 Median $16.22 Typical High $60.26 | Facility | None | $11.75 | $16.22 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $11.22 Median $12.30 Typical High $16.98 | Professional | None (both parts) | $11.22 | $12.30 | $16.98 |
Oscar Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None (both parts) Typical Low $11.48 Median $13.18 Typical High $15.85 | Professional | None (both parts) | $11.48 | $13.18 | $15.85 |
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 GP · Physical therapy plan Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | GP · Physical therapy plan | $10.00 | $10.96 | $10.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.79 Median $5.01 Typical High $6.76 | Professional | 26 · Professional part | $4.79 | $5.01 | $6.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.62 Median $6.17 Typical High $8.71 | Professional | 51 · Multiple procedures | $5.62 | $6.17 | $8.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.24 Median $2.45 Typical High $3.47 | Professional | 80 · Assistant surgeon | $2.24 | $2.45 | $3.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.58 Median $1.74 Typical High $2.45 | Professional | 81 · Minimal assistant surgeon | $1.58 | $1.74 | $2.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.58 Median $1.74 Typical High $2.45 | Professional | 82 · Assistant surgeon, no resident | $1.58 | $1.74 | $2.45 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.58 Median $1.74 Typical High $2.45 | Professional | AS · PA/NP assist | $1.58 | $1.74 | $2.45 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $7.24 Median $7.41 Typical High $10.23 | Professional | TC · Technical part | $7.24 | $7.41 | $10.23 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 42nd of 51
$11.22
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.