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 $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3.31 Median $4.37 Typical High $4.79 | Professional | None | $3.31 | $4.37 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $10.23 Typical High $16.98 | Professional | None | $7.76 | $10.23 | $16.98 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Oscar Health Setting Professional Modifier None Typical Low $7.59 Median $12.30 Typical High $12.30 | Professional | None | $7.59 | $12.30 | $12.30 |
United Setting Professional Modifier None Typical Low $4.37 Median $5.37 Typical High $12.30 | Professional | None | $4.37 | $5.37 | $12.30 |
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 $2.51 Median $2.51 Typical High $2.51 | Professional | 51 · Multiple procedures | $2.51 | $2.51 | $2.51 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 80 · Assistant surgeon | $1.00 | $1.00 | $1.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 81 · Minimal assistant surgeon | $0.71 | $0.71 | $0.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 82 · Assistant surgeon, no resident | $0.71 | $0.71 | $0.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | AS · PA/NP assist | $0.71 | $0.71 | $0.71 |
Oscar Health Setting Professional Modifier HM · Below bachelor's level Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | HM · Below bachelor's level | $9.33 | $9.33 | $9.33 |
Oscar Health Setting Professional Modifier HN · Bachelor's level Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | HN · Bachelor's level | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier HM · Below bachelor's level Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | HM · Below bachelor's level | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier HN · Bachelor's level Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | HN · Bachelor's level | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier HO · Master's level Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | HO · Master's level | $12.30 | $12.30 | $12.30 |
United Setting Professional Modifier HP · Doctoral level Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | HP · Doctoral level | $12.30 | $12.30 | $12.30 |
Where North Carolina sits
The same service costs 11.0 times more in Washington, DC than in Alabama. 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· 45th of 51
$4.57
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.