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 $27.54 Median $32.36 Typical High $67.61 | Facility | None | $27.54 | $32.36 | $67.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $27.54 Typical High $33.11 | Professional | None (both parts) | $22.91 | $27.54 | $33.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $46.77 | Facility | None | $33.11 | $38.90 | $46.77 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $21.88 Median $25.12 Typical High $48.98 | Professional | None (both parts) | $21.88 | $25.12 | $48.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.44 Median $24.55 Typical High $47.86 | Professional | None (both parts) | $23.44 | $24.55 | $47.86 |
Medcost Setting Facility Modifier None Typical Low $27.54 Median $37.15 Typical High $60.26 | Facility | None | $27.54 | $37.15 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $25.70 Median $31.62 Typical High $33.11 | Professional | None (both parts) | $25.70 | $31.62 | $33.11 |
United Setting Professional Modifier None (both parts) Typical Low $26.30 Median $31.62 Typical High $35.48 | Professional | None (both parts) | $26.30 | $31.62 | $35.48 |
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 $22.39 Median $25.12 Typical High $41.69 | Professional | GO · Occupational therapy plan | $22.39 | $25.12 | $41.69 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $22.39 Median $25.12 Typical High $25.12 | Professional | GP · Physical therapy plan | $22.39 | $25.12 | $25.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.48 Median $12.88 Typical High $13.18 | Professional | 26 · Professional part | $11.48 | $12.88 | $13.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $15.85 Typical High $16.60 | Professional | 51 · Multiple procedures | $12.88 | $15.85 | $16.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.13 Median $6.46 Typical High $6.61 | Professional | 80 · Assistant surgeon | $5.13 | $6.46 | $6.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.63 Median $4.47 Typical High $4.57 | Professional | 81 · Minimal assistant surgeon | $3.63 | $4.47 | $4.57 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.63 Median $4.47 Typical High $4.57 | Professional | 82 · Assistant surgeon, no resident | $3.63 | $4.47 | $4.57 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.63 Median $4.47 Typical High $4.57 | Professional | AS · PA/NP assist | $3.63 | $4.47 | $4.57 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $19.05 Typical High $19.95 | Professional | TC · Technical part | $17.38 | $19.05 | $19.95 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Ohio. 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· 43rd of 51
$25.70
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.