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 $97.72 Median $114.82 Typical High $151.36 | Facility | None | $97.72 | $114.82 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $169.82 | Professional | None | $79.43 | $128.82 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $177.83 | Professional | None | $70.79 | $125.89 | $177.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $239.88 | Professional | None | $112.20 | $165.96 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $213.80 | Professional | None | $72.44 | $114.82 | $213.80 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $181.97 | Facility | None | $151.36 | $151.36 | $181.97 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $147.91 | Professional | None | $64.57 | $102.33 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $173.78 | Professional | None | $79.43 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $190.55 | Professional | None | $77.62 | $102.33 | $190.55 |
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 $36.31 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $36.31 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $9.77 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $125.89 Typical High $177.83 | Professional | 25 · Same-day visit | $60.26 | $125.89 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $51.29 Typical High $123.03 | Professional | 51 · Multiple procedures | $32.36 | $51.29 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.88 Median $20.89 Typical High $48.98 | Professional | 80 · Assistant surgeon | $12.88 | $20.89 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.12 Median $14.45 Typical High $34.67 | Professional | 81 · Minimal assistant surgeon | $9.12 | $14.45 | $34.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.12 Median $14.45 Typical High $34.67 | Professional | 82 · Assistant surgeon, no resident | $9.12 | $14.45 | $34.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.12 Median $14.45 Typical High $34.67 | Professional | AS · PA/NP assist | $9.12 | $14.45 | $34.67 |
Where North Carolina sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 4th of 51
$155
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.