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 $15.49 Median $15.49 Typical High $128.82 | Facility | None | $15.49 | $15.49 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | None | $23.99 | $24.55 | $24.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $35.48 | Professional | None | $24.55 | $32.36 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $46.77 | Professional | None | $10.00 | $12.88 | $46.77 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $16.60 | Facility | None | $15.49 | $15.49 | $16.60 |
Medcost Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $81.28 | Professional | None | $28.84 | $37.15 | $81.28 |
11 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 51 · Multiple procedures | $17.78 | $17.78 | $17.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 80 · Assistant surgeon | $7.24 | $7.24 | $7.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 81 · Minimal assistant surgeon | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 82 · Assistant surgeon, no resident | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | AS · PA/NP assist | $5.01 | $5.01 | $5.01 |
Oscar Health Setting Professional Modifier HM · Below bachelor's level Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | HM · Below bachelor's level | $12.59 | $12.59 | $12.59 |
Oscar Health Setting Professional Modifier HN · Bachelor's level Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | HN · Bachelor's level | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier HM · Below bachelor's level Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | HM · Below bachelor's level | $12.59 | $12.59 | $12.59 |
United Setting Professional Modifier HN · Bachelor's level Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | HN · Bachelor's level | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier HO · Master's level Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | HO · Master's level | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier HP · Doctoral level Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | HP · Doctoral level | $16.60 | $16.60 | $16.60 |
Where North Carolina sits
The same service costs 4.5 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· 2nd of 51
$32.36
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.