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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | None | $17.78 | $17.78 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | None | $16.22 | $16.22 | $22.91 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $27.54 | Facility | None | $19.05 | $19.05 | $27.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $58.88 | Professional | None | $19.95 | $26.30 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $37.15 | Professional | None | $20.42 | $21.38 | $37.15 |
Medcost Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $23.99 | Facility | None | $17.78 | $17.78 | $23.99 |
Medcost Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $20.89 | Professional | None | $14.45 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $32.36 | Professional | None | $17.38 | $19.05 | $32.36 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $8.91 Typical High $9.77 | Professional | 52 · Reduced service | $8.91 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.89 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.89 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $16.22 Median $16.22 Typical High $32.36 | Professional | GP · Physical therapy plan | $16.22 | $16.22 | $32.36 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.08 Median $10.47 Typical High $10.47 | Professional | 51 · Multiple procedures | $7.08 | $10.47 | $10.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.88 Median $4.17 Typical High $4.17 | Professional | 80 · Assistant surgeon | $2.88 | $4.17 | $4.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.00 Median $2.95 Typical High $2.95 | Professional | 81 · Minimal assistant surgeon | $2.00 | $2.95 | $2.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.00 Median $2.95 Typical High $2.95 | Professional | 82 · Assistant surgeon, no resident | $2.00 | $2.95 | $2.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.00 Median $2.95 Typical High $2.95 | Professional | AS · PA/NP assist | $2.00 | $2.95 | $2.95 |
Where North Carolina sits
The same service costs 2.3 times more in Minnesota than in Kentucky. 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· 17th of 51
$26.30
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.