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 $30.20 Median $38.90 Typical High $38.90 | Facility | None | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $40.74 | Professional | None | $30.20 | $33.11 | $40.74 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | None | $33.88 | $39.81 | $39.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $25.70 Median $52.48 Typical High $134.90 | Professional | None | $25.70 | $52.48 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $63.10 | Professional | None | $33.11 | $42.66 | $63.10 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $38.90 Typical High $46.77 | Facility | None | $30.20 | $38.90 | $46.77 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $46.77 | Professional | None | $30.90 | $46.77 | $46.77 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $58.88 | Professional | None | $29.51 | $38.02 | $58.88 |
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 $15.14 Median $15.85 Typical High $19.50 | Professional | 52 · Reduced service | $15.14 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.31 Typical High $7.76 | Professional | 53 · Discontinued | $6.03 | $6.31 | $7.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $15.14 Median $23.44 Typical High $23.44 | Professional | 51 · Multiple procedures | $15.14 | $23.44 | $23.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.17 Median $9.33 Typical High $9.33 | Professional | 80 · Assistant surgeon | $6.17 | $9.33 | $9.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.27 Median $6.46 Typical High $6.46 | Professional | 81 · Minimal assistant surgeon | $4.27 | $6.46 | $6.46 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.27 Median $6.46 Typical High $6.46 | Professional | 82 · Assistant surgeon, no resident | $4.27 | $6.46 | $6.46 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.27 Median $6.46 Typical High $6.46 | Professional | AS · PA/NP assist | $4.27 | $6.46 | $6.46 |
Where North Carolina sits
The same service costs 2.4 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· 16th of 51
$45.71
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.