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 $141.25 Median $186.21 Typical High $213.80 | Facility | None | $141.25 | $186.21 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $199.53 | Professional | None | $141.25 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | 52 · Reduced service | $70.79 | $70.79 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | None | $177.83 | $208.93 | $245.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $263.03 | Professional | None | $95.50 | $165.96 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $309.03 | Professional | None | $147.91 | $190.55 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $251.19 | Facility | None | $141.25 | $141.25 | $251.19 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | None | $125.89 | $125.89 | $177.83 |
United Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $316.23 | Professional | None | $123.03 | $177.83 | $316.23 |
6 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 $204.17 Median $251.19 Typical High $295.12 | Professional | 25 · Same-day visit | $204.17 | $251.19 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | 51 · Multiple procedures | $63.10 | $63.10 | $89.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | 80 · Assistant surgeon | $25.12 | $25.12 | $35.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | 81 · Minimal assistant surgeon | $17.78 | $17.78 | $24.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | 82 · Assistant surgeon, no resident | $17.78 | $17.78 | $24.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | AS · PA/NP assist | $17.78 | $17.78 | $24.55 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 17th of 51
$174
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.