How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $11.22 Median $12.88 Typical High $12.88 | Facility | None | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $13.80 | Professional | None | $11.22 | $12.88 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.22 | Professional | None | $8.13 | $8.13 | $11.22 |
BCBS North Carolina Setting Professional Modifier None Typical Low $10.00 Median $17.38 Typical High $39.81 | Professional | None | $10.00 | $17.38 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.88 Typical High $26.92 | Professional | None | $12.30 | $12.88 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | None | $17.78 | $17.78 | $25.70 |
Medcost Setting Facility Modifier None Typical Low $11.22 Median $12.88 Typical High $15.49 | Facility | None | $11.22 | $12.88 | $15.49 |
Medcost Setting Professional Modifier None Typical Low $10.23 Median $14.45 Typical High $15.14 | Professional | None | $10.23 | $14.45 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $12.59 | Professional | None | $10.23 | $12.02 | $12.59 |
United Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $20.42 | Professional | None | $10.23 | $12.88 | $20.42 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.13 Median $7.08 Typical High $7.59 | Professional | 51 · Multiple procedures | $5.13 | $7.08 | $7.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.04 Median $2.88 Typical High $3.09 | Professional | 80 · Assistant surgeon | $2.04 | $2.88 | $3.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.45 Median $2.00 Typical High $2.14 | Professional | 81 · Minimal assistant surgeon | $1.45 | $2.00 | $2.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.45 Median $2.00 Typical High $2.14 | Professional | 82 · Assistant surgeon, no resident | $1.45 | $2.00 | $2.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.45 Median $2.00 Typical High $2.14 | Professional | AS · PA/NP assist | $1.45 | $2.00 | $2.14 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in New York. 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· 24th of 51
$15.14
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.