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 $38.02 Median $97.72 Typical High $128.82 | Facility | None | $38.02 | $97.72 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $87.10 Typical High $128.82 | Professional | None | $38.02 | $87.10 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $70.79 | Professional | None | $37.15 | $53.70 | $70.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $93.33 | Professional | None | $51.29 | $72.44 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $83.18 | Professional | None | $36.31 | $50.12 | $83.18 |
Medcost Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $138.04 | Facility | None | $114.82 | $114.82 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $81.28 | Professional | None | $38.90 | $42.66 | $81.28 |
Oscar Health Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $102.33 | Professional | None | $45.71 | $75.86 | $102.33 |
United Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $95.50 | Professional | None | $34.67 | $46.77 | $95.50 |
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 $15.85 Median $18.62 Typical High $20.89 | Professional | 52 · Reduced service | $15.85 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.62 Typical High $6.31 | Professional | 55 · Aftercare only | $4.79 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.80 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.16 | $3.80 | $4.17 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $53.70 Median $67.61 Typical High $69.18 | Professional | 25 · Same-day visit | $53.70 | $67.61 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.05 Median $21.38 Typical High $54.95 | Professional | 51 · Multiple procedures | $19.05 | $21.38 | $54.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.59 Median $8.51 Typical High $22.39 | Professional | 80 · Assistant surgeon | $7.59 | $8.51 | $22.39 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.37 Median $6.03 Typical High $15.49 | Professional | 81 · Minimal assistant surgeon | $5.37 | $6.03 | $15.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.37 Median $6.03 Typical High $15.49 | Professional | 82 · Assistant surgeon, no resident | $5.37 | $6.03 | $15.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.37 Median $6.03 Typical High $15.49 | Professional | AS · PA/NP assist | $5.37 | $6.03 | $15.49 |
Where North Carolina sits
The same service costs 2.7 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· 11th of 51
$69.18
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.