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 $85.11 Median $85.11 Typical High $144.54 | Facility | None | $85.11 | $85.11 | $144.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $70.79 | $85.11 | $85.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Facility | None | $102.33 | $102.33 | $144.54 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $67.61 Median $87.10 Typical High $144.54 | Professional | None (both parts) | $67.61 | $87.10 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $67.61 Typical High $134.90 | Professional | None (both parts) | $64.57 | $67.61 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $114.82 | Facility | None | $85.11 | $85.11 | $114.82 |
Medcost Setting Professional Modifier None (both parts) Typical Low $79.43 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $79.43 | $107.15 | $107.15 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $83.18 Typical High $97.72 | Professional | None (both parts) | $72.44 | $83.18 | $97.72 |
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 $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $35.48 | $42.66 | $42.66 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | GO · Occupational therapy plan | $77.62 | $77.62 | $77.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 26 · Professional part | $38.02 | $42.66 | $42.66 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 51 · Multiple procedures | $39.81 | $53.70 | $53.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.85 Median $21.38 Typical High $21.38 | Professional | 80 · Assistant surgeon | $15.85 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $15.14 Typical High $15.14 | Professional | 81 · Minimal assistant surgeon | $10.96 | $15.14 | $15.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $15.14 Typical High $15.14 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $15.14 | $15.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $15.14 Typical High $15.14 | Professional | AS · PA/NP assist | $10.96 | $15.14 | $15.14 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | TC · Technical part | $57.54 | $64.57 | $64.57 |
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· 25th of 51
$87.10
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.