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 $52.48 Median $52.48 Typical High $79.43 | Facility | None | $52.48 | $52.48 | $79.43 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | None (both parts) | $52.48 | $52.48 | $54.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $70.79 | Facility | None | $56.23 | $69.18 | $70.79 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $38.90 Typical High $85.11 | Professional | None (both parts) | $33.11 | $38.90 | $85.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $39.81 Median $41.69 Typical High $77.62 | Professional | None (both parts) | $39.81 | $41.69 | $77.62 |
Medcost Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $56.23 | Facility | None | $52.48 | $52.48 | $56.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | None (both parts) | $40.74 | $56.23 | $56.23 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $48.98 Typical High $56.23 | Professional | None (both parts) | $43.65 | $48.98 | $56.23 |
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 $26.30 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | GO · Occupational therapy plan | $61.66 | $61.66 | $63.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $22.39 Typical High $22.39 | Professional | 26 · Professional part | $19.95 | $22.39 | $22.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $28.18 Typical High $28.18 | Professional | 51 · Multiple procedures | $20.42 | $28.18 | $28.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $11.22 Typical High $11.22 | Professional | 80 · Assistant surgeon | $8.13 | $11.22 | $11.22 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $7.76 Typical High $7.76 | Professional | 81 · Minimal assistant surgeon | $5.75 | $7.76 | $7.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $7.76 Typical High $7.76 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $7.76 | $7.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.75 Median $7.76 Typical High $7.76 | Professional | AS · PA/NP assist | $5.75 | $7.76 | $7.76 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | TC · Technical part | $30.20 | $33.11 | $33.11 |
Where North Carolina sits
The same service costs 3.5 times more in Alaska than in Utah. 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· 47th of 51
$41.69
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.