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 $30.90 Median $36.31 Typical High $77.62 | Facility | None | $30.90 | $36.31 | $77.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $30.90 Typical High $37.15 | Professional | None (both parts) | $25.70 | $30.90 | $37.15 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None (both parts) | $33.88 | $33.88 | $33.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $36.31 Median $39.81 Typical High $52.48 | Facility | None | $36.31 | $39.81 | $52.48 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $26.92 Typical High $51.29 | Professional | None (both parts) | $23.44 | $26.92 | $51.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.99 Typical High $53.70 | Professional | None (both parts) | $23.44 | $23.99 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $30.90 Median $39.81 Typical High $60.26 | Facility | None | $30.90 | $39.81 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.92 Median $31.62 Typical High $42.66 | Professional | None (both parts) | $26.92 | $31.62 | $42.66 |
United Setting Professional Modifier None (both parts) Typical Low $27.54 Median $34.67 Typical High $39.81 | Professional | None (both parts) | $27.54 | $34.67 | $39.81 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $26.92 Median $26.92 Typical High $53.70 | Professional | GO · Occupational therapy plan | $26.92 | $26.92 | $53.70 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $26.92 Median $26.92 Typical High $52.48 | Professional | GP · Physical therapy plan | $26.92 | $26.92 | $52.48 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $12.88 Typical High $17.38 | Professional | 26 · Professional part | $10.72 | $12.88 | $17.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.49 Median $15.85 Typical High $20.89 | Professional | 51 · Multiple procedures | $13.49 | $15.85 | $20.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.37 Median $6.31 Typical High $8.32 | Professional | 80 · Assistant surgeon | $5.37 | $6.31 | $8.32 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.80 Median $4.47 Typical High $5.89 | Professional | 81 · Minimal assistant surgeon | $3.80 | $4.47 | $5.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.80 Median $4.47 Typical High $5.89 | Professional | 82 · Assistant surgeon, no resident | $3.80 | $4.47 | $5.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.80 Median $4.47 Typical High $5.89 | Professional | AS · PA/NP assist | $3.80 | $4.47 | $5.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.22 Median $19.05 Typical High $25.12 | Professional | TC · Technical part | $16.22 | $19.05 | $25.12 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in 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· 42nd of 51
$27.54
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.