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 $75.86 Median $83.18 Typical High $83.18 | Facility | None | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $104.71 | Professional | None | $66.07 | $77.62 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $138.04 | Professional | None | $64.57 | $109.65 | $138.04 |
BCBS North Carolina Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $204.17 | Professional | None | $104.71 | $154.88 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $169.82 | Professional | None | $75.86 | $117.49 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $75.86 Median $83.18 Typical High $100.00 | Facility | None | $75.86 | $83.18 | $100.00 |
Medcost Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | None | $75.86 | $95.50 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $186.21 | Professional | None | $72.44 | $128.82 | $186.21 |
United Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $134.90 | Professional | None | $72.44 | $83.18 | $134.90 |
8 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 $32.36 Median $38.02 Typical High $41.69 | Professional | 52 · Reduced service | $32.36 | $38.02 | $41.69 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $53.70 Median $70.79 Typical High $95.50 | Professional | 25 · Same-day visit | $53.70 | $70.79 | $95.50 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 33 · Preventive service | $83.18 | $83.18 | $100.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 51 · Multiple procedures | $33.11 | $47.86 | $47.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $19.05 Typical High $19.05 | Professional | 80 · Assistant surgeon | $13.49 | $19.05 | $19.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 81 · Minimal assistant surgeon | $9.33 | $13.49 | $13.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $13.49 | $13.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | AS · PA/NP assist | $9.33 | $13.49 | $13.49 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in New York. 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· 3rd of 51
$145
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.