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 $20.89 Median $20.89 Typical High $128.82 | Facility | None | $20.89 | $20.89 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $52.48 | Professional | None | $36.31 | $47.86 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $70.79 | Professional | None | $20.89 | $23.99 | $70.79 |
Medcost Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $22.39 | Facility | None | $20.89 | $20.89 | $22.39 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier HN · Bachelor's level Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | HN · Bachelor's level | $25.12 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $120.23 | Professional | None | $41.69 | $53.70 | $120.23 |
United Setting Professional Modifier HN · Bachelor's level Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | HN · Bachelor's level | $25.12 | $25.12 | $25.12 |
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 U3 · State-defined Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | U3 · State-defined | $26.92 | $26.92 | $26.92 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 51 · Multiple procedures | $26.30 | $26.30 | $26.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 80 · Assistant surgeon | $10.47 | $10.47 | $10.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 81 · Minimal assistant surgeon | $7.24 | $7.24 | $7.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 82 · Assistant surgeon, no resident | $7.24 | $7.24 | $7.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | AS · PA/NP assist | $7.24 | $7.24 | $7.24 |
United Setting Professional Modifier HO · Master's level Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | HO · Master's level | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier HP · Doctoral level Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | HP · Doctoral level | $30.20 | $30.20 | $30.20 |
Where North Carolina sits
The same service costs 4.8 times more in Wyoming than in West 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· 6th of 51
$47.86
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.