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 $40.74 Median $40.74 Typical High $63.10 | Facility | None | $40.74 | $40.74 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $29.51 | $40.74 | $40.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $67.61 | Facility | None | $47.86 | $47.86 | $67.61 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $28.84 Median $35.48 Typical High $58.88 | Professional | None (both parts) | $28.84 | $35.48 | $58.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $20.89 Median $25.12 Typical High $43.65 | Professional | None (both parts) | $20.89 | $25.12 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $52.48 Typical High $60.26 | Facility | None | $40.74 | $52.48 | $60.26 |
Medcost Setting Professional Modifier None (both parts) Typical Low $29.51 Median $33.88 Typical High $38.02 | Professional | None (both parts) | $29.51 | $33.88 | $38.02 |
United Setting Professional Modifier None (both parts) Typical Low $27.54 Median $40.74 Typical High $47.86 | Professional | None (both parts) | $27.54 | $40.74 | $47.86 |
8 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 GP · Physical therapy plan Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | GP · Physical therapy plan | $35.48 | $35.48 | $38.90 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $11.75 Median $13.49 Typical High $18.20 | Professional | 26 · Professional part | $11.75 | $13.49 | $18.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $14.79 Median $16.98 Typical High $18.62 | Professional | 51 · Multiple procedures | $14.79 | $16.98 | $18.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.89 Median $6.76 Typical High $7.59 | Professional | 80 · Assistant surgeon | $5.89 | $6.76 | $7.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.17 Median $4.79 Typical High $5.25 | Professional | 81 · Minimal assistant surgeon | $4.17 | $4.79 | $5.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.17 Median $4.79 Typical High $5.25 | Professional | 82 · Assistant surgeon, no resident | $4.17 | $4.79 | $5.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.17 Median $4.79 Typical High $5.25 | Professional | AS · PA/NP assist | $4.17 | $4.79 | $5.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $17.78 Median $20.42 Typical High $27.54 | Professional | TC · Technical part | $17.78 | $20.42 | $27.54 |
Where North Carolina sits
The same service costs 3.5 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· 41st of 51
$35.48
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.