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 $83.18 Median $83.18 Typical High $134.90 | Facility | None | $83.18 | $83.18 | $134.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $83.18 Typical High $91.20 | Professional | None (both parts) | $70.79 | $83.18 | $91.20 |
BCBS North Carolina Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $144.54 | Facility | None | $95.50 | $100.00 | $144.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $66.07 Median $85.11 Typical High $147.91 | Professional | None (both parts) | $66.07 | $85.11 | $147.91 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $69.18 Typical High $134.90 | Professional | None (both parts) | $66.07 | $69.18 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Facility | None | $83.18 | $83.18 | $112.20 |
Medcost Setting Professional Modifier None (both parts) Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $79.43 | $95.50 | $95.50 |
United Setting Professional Modifier None (both parts) Typical Low $74.13 Median $83.18 Typical High $100.00 | Professional | None (both parts) | $74.13 | $83.18 | $100.00 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $35.48 | $41.69 | $41.69 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | GP · Physical therapy plan | $75.86 | $75.86 | $79.43 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 26 · Professional part | $38.02 | $38.02 | $38.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $47.86 Typical High $47.86 | Professional | 51 · Multiple procedures | $39.81 | $47.86 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $19.05 Typical High $19.05 | Professional | 80 · Assistant surgeon | $15.85 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 81 · Minimal assistant surgeon | $10.96 | $13.18 | $13.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $13.18 | $13.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | AS · PA/NP assist | $10.96 | $13.18 | $13.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | TC · Technical part | $57.54 | $57.54 | $57.54 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Florida. 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· 28th of 51
$83.18
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.