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 $25.12 Median $27.54 Typical High $38.90 | Facility | None | $25.12 | $27.54 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $30.90 | Professional | None | $23.44 | $25.70 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $27.54 Typical High $45.71 | Professional | None | $23.44 | $27.54 | $45.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $61.66 | Professional | None | $31.62 | $46.77 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $48.98 | Professional | None | $22.91 | $25.70 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $52.48 | Professional | None | $30.20 | $30.20 | $52.48 |
Medcost Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $33.11 | Facility | None | $25.12 | $27.54 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $28.18 | Professional | None | $21.38 | $23.44 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | None | $28.84 | $28.84 | $30.20 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $41.69 | Professional | None | $20.89 | $25.70 | $41.69 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 25 · Same-day visit | $27.54 | $27.54 | $27.54 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 33 · Preventive service | $23.44 | $23.44 | $23.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.72 Median $11.75 Typical High $14.13 | Professional | 51 · Multiple procedures | $10.72 | $11.75 | $14.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.27 Median $4.68 Typical High $5.62 | Professional | 80 · Assistant surgeon | $4.27 | $4.68 | $5.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.02 Median $3.24 Typical High $3.89 | Professional | 81 · Minimal assistant surgeon | $3.02 | $3.24 | $3.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.02 Median $3.24 Typical High $3.89 | Professional | 82 · Assistant surgeon, no resident | $3.02 | $3.24 | $3.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.02 Median $3.24 Typical High $3.89 | Professional | AS · PA/NP assist | $3.02 | $3.24 | $3.89 |
Where North Carolina sits
The same service costs 3.0 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· 5th of 51
$43.65
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.