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 $24.55 Median $29.51 Typical High $63.10 | Facility | None | $24.55 | $29.51 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $20.89 Median $24.55 Typical High $30.90 | Professional | None (both parts) | $20.89 | $24.55 | $30.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $42.66 | Facility | None | $29.51 | $29.51 | $42.66 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $19.50 Median $23.44 Typical High $45.71 | Professional | None (both parts) | $19.50 | $23.44 | $45.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $21.38 Median $22.91 Typical High $43.65 | Professional | None (both parts) | $21.38 | $22.91 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $24.55 Median $33.11 Typical High $60.26 | Facility | None | $24.55 | $33.11 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $22.91 Median $29.51 Typical High $36.31 | Professional | None (both parts) | $22.91 | $29.51 | $36.31 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $29.51 Typical High $33.88 | Professional | None (both parts) | $25.12 | $29.51 | $33.88 |
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 $22.39 Median $22.39 Typical High $41.69 | Professional | GO · Occupational therapy plan | $22.39 | $22.39 | $41.69 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $19.95 Median $22.39 Typical High $41.69 | Professional | GP · Physical therapy plan | $19.95 | $22.39 | $41.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $12.02 Typical High $14.45 | Professional | 26 · Professional part | $10.72 | $12.02 | $14.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $11.48 Median $14.79 Typical High $18.62 | Professional | 51 · Multiple procedures | $11.48 | $14.79 | $18.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.57 Median $5.89 Typical High $7.41 | Professional | 80 · Assistant surgeon | $4.57 | $5.89 | $7.41 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.24 Median $4.17 Typical High $5.25 | Professional | 81 · Minimal assistant surgeon | $3.24 | $4.17 | $5.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.24 Median $4.17 Typical High $5.25 | Professional | 82 · Assistant surgeon, no resident | $3.24 | $4.17 | $5.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.24 Median $4.17 Typical High $5.25 | Professional | AS · PA/NP assist | $3.24 | $4.17 | $5.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.22 Median $17.78 Typical High $21.38 | Professional | TC · Technical part | $16.22 | $17.78 | $21.38 |
Where North Carolina sits
The same service costs 3.5 times more in Minnesota than in Ohio. 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· 40th of 51
$23.99
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.