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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | None | $51.29 | $51.29 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $169.82 | Professional | None | $48.98 | $77.62 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $104.71 | Professional | None | $58.88 | $61.66 | $104.71 |
Medcost Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Medcost Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $50.12 | Professional | None | $37.15 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $93.33 | Professional | None | $47.86 | $54.95 | $93.33 |
7 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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | 51 · Multiple procedures | $18.62 | $25.12 | $25.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.41 Median $10.00 Typical High $10.00 | Professional | 80 · Assistant surgeon | $7.41 | $10.00 | $10.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $5.25 | $7.08 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $5.25 | $7.08 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.25 Median $7.08 Typical High $7.08 | Professional | AS · PA/NP assist | $5.25 | $7.08 | $7.08 |
Where North Carolina sits
The same service costs 2.6 times more in Nebraska 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· 15th of 51
$74.13
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.