How much rates vary
Facilitymedian $63 · 10th to 90th $48 to $98Professionalmedian $85 · 10th to 90th $52 to $155
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 $47.86 Median $60.26 Typical High $74.13 | Facility | None | $47.86 | $60.26 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $77.62 | Professional | None | $45.71 | $60.26 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $117.49 | Professional | None | $54.95 | $70.79 | $117.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $158.49 | Professional | None | $66.07 | $100.00 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $151.36 | Facility | None | $95.50 | $114.82 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $102.33 | Professional | None | $50.12 | $67.61 | $102.33 |
Medcost Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $91.20 | Professional | None | $61.66 | $79.43 | $91.20 |
Medcost Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $85.11 | Facility | None | $47.86 | $70.79 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $93.33 | Professional | None | $52.48 | $72.44 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $47.86 Median $74.13 Typical High $147.91 | Professional | None | $47.86 | $74.13 | $147.91 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $95.50 | Professional | None | $42.66 | $61.66 | $95.50 |
15 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 Facility Modifier 52 · Reduced service Typical Low $23.99 Median $27.54 Typical High $35.48 | Facility | 52 · Reduced service | $23.99 | $27.54 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $8.32 Typical High $10.72 | Facility | 55 · Aftercare only | $7.24 | $8.32 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.50 Typical High $7.08 | Facility | 56 · Pre-op care only | $4.79 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $26.92 Typical High $35.48 | Professional | 52 · Reduced service | $23.99 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.13 Typical High $10.72 | Professional | 55 · Aftercare only | $7.24 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $7.08 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | 25 · Same-day visit | $60.26 | $70.79 | $75.86 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | EP · Child screening program | $70.79 | $70.79 | $70.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $36.31 Typical High $47.86 | Professional | 51 · Multiple procedures | $28.18 | $36.31 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.48 Median $14.45 Typical High $19.05 | Professional | 80 · Assistant surgeon | $11.48 | $14.45 | $19.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.94 Median $10.23 Typical High $13.49 | Professional | 81 · Minimal assistant surgeon | $7.94 | $10.23 | $13.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.94 Median $10.23 Typical High $13.49 | Professional | 82 · Assistant surgeon, no resident | $7.94 | $10.23 | $13.49 |
Medcost Setting Professional Modifier 93 · Audio-only telehealth Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 93 · Audio-only telehealth | $50.12 | $50.12 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.94 Median $10.23 Typical High $13.49 | Professional | AS · PA/NP assist | $7.94 | $10.23 | $13.49 |
Medcost Setting Professional Modifier FQ · Audio-only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | FQ · Audio-only | $50.12 | $50.12 | $50.12 |
Where North Carolina sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 8th of 51
$85.11
AK $107NJ $48.98
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.