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 $28.18 Typical High $45.71 | Facility | None | $27.54 | $28.18 | $45.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $28.18 Typical High $28.18 | Professional | None (both parts) | $22.91 | $28.18 | $28.18 |
BCBS North Carolina Setting Facility Modifier None Typical Low $33.88 Median $38.02 Typical High $48.98 | Facility | None | $33.88 | $38.02 | $48.98 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $22.91 Median $28.84 Typical High $52.48 | Professional | None (both parts) | $22.91 | $28.84 | $52.48 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $24.55 Typical High $48.98 | Professional | None (both parts) | $22.91 | $24.55 | $48.98 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $38.90 Typical High $60.26 | Facility | None | $28.18 | $38.90 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $26.30 Median $30.90 Typical High $38.90 | Professional | None (both parts) | $26.30 | $30.90 | $38.90 |
United Setting Professional Modifier None (both parts) Typical Low $26.30 Median $30.90 Typical High $35.48 | Professional | None (both parts) | $26.30 | $30.90 | $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 $25.70 Median $25.70 Typical High $25.70 | Professional | GO · Occupational therapy plan | $25.70 | $25.70 | $25.70 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | GP · Physical therapy plan | $25.70 | $25.70 | $43.65 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.22 Median $12.30 Typical High $15.49 | Professional | 26 · Professional part | $11.22 | $12.30 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $13.18 Median $15.49 Typical High $19.50 | Professional | 51 · Multiple procedures | $13.18 | $15.49 | $19.50 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.25 Median $6.17 Typical High $7.76 | Professional | 80 · Assistant surgeon | $5.25 | $6.17 | $7.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.72 Median $4.27 Typical High $5.50 | Professional | 81 · Minimal assistant surgeon | $3.72 | $4.27 | $5.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.72 Median $4.27 Typical High $5.50 | Professional | 82 · Assistant surgeon, no resident | $3.72 | $4.27 | $5.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.72 Median $4.27 Typical High $5.50 | Professional | AS · PA/NP assist | $3.72 | $4.27 | $5.50 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $18.62 Typical High $23.44 | Professional | TC · Technical part | $16.98 | $18.62 | $23.44 |
Where North Carolina sits
The same service costs 3.2 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· 39th of 51
$28.18
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.