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 $15.49 Median $15.49 Typical High $25.70 | Facility | None | $15.49 | $15.49 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $16.60 | Professional | None | $14.45 | $15.49 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $30.90 | Professional | None | $17.78 | $23.44 | $30.90 |
BCBS North Carolina Setting Professional Modifier None Typical Low $18.62 Median $25.70 Typical High $39.81 | Professional | None | $18.62 | $25.70 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | None | $25.70 | $26.92 | $26.92 |
Medcost Setting Facility Modifier None Typical Low $15.49 Median $18.20 Typical High $26.92 | Facility | None | $15.49 | $18.20 | $26.92 |
Medcost Setting Professional Modifier None Typical Low $10.47 Median $12.02 Typical High $18.62 | Professional | None | $10.47 | $12.02 | $18.62 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $38.90 | Professional | None | $16.60 | $30.20 | $38.90 |
United Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $25.12 | Professional | None | $12.88 | $15.49 | $25.12 |
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 $7.08 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $7.08 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.29 Typical High $2.34 | Professional | 55 · Aftercare only | $2.14 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.55 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.45 | $1.55 | $1.55 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.25 Median $6.03 Typical High $10.96 | Professional | 51 · Multiple procedures | $5.25 | $6.03 | $10.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.09 Median $2.40 Typical High $4.37 | Professional | 80 · Assistant surgeon | $2.09 | $2.40 | $4.37 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.48 Median $1.66 Typical High $3.09 | Professional | 81 · Minimal assistant surgeon | $1.48 | $1.66 | $3.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.48 Median $1.66 Typical High $3.09 | Professional | 82 · Assistant surgeon, no resident | $1.48 | $1.66 | $3.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.48 Median $1.66 Typical High $3.09 | Professional | AS · PA/NP assist | $1.48 | $1.66 | $3.09 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 9th of 51
$23.99
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.