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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $15.85 | Professional | None | $12.59 | $12.59 | $15.85 |
BCBS North Carolina Setting Professional Modifier None Typical Low $12.02 Median $16.98 Typical High $22.39 | Professional | None | $12.02 | $16.98 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Medcost Setting Professional Modifier None Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | None | $13.18 | $13.80 | $13.80 |
Medcost Setting Facility Modifier None Typical Low $8.13 Median $8.71 Typical High $10.47 | Facility | None | $8.13 | $8.71 | $10.47 |
Medcost Setting Professional Modifier None Typical Low $6.03 Median $9.12 Typical High $10.00 | Professional | None | $6.03 | $9.12 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
United Setting Professional Modifier None Typical Low $8.13 Median $9.12 Typical High $15.14 | Professional | None | $8.13 | $9.12 | $15.14 |
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 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.35 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $3.02 Median $4.57 Typical High $5.01 | Professional | 51 · Multiple procedures | $3.02 | $4.57 | $5.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1.20 Median $1.82 Typical High $2.00 | Professional | 80 · Assistant surgeon | $1.20 | $1.82 | $2.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.83 Median $1.29 Typical High $1.41 | Professional | 81 · Minimal assistant surgeon | $0.83 | $1.29 | $1.41 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.83 Median $1.29 Typical High $1.41 | Professional | 82 · Assistant surgeon, no resident | $0.83 | $1.29 | $1.41 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.83 Median $1.29 Typical High $1.41 | Professional | AS · PA/NP assist | $0.83 | $1.29 | $1.41 |
Where North Carolina sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 2nd of 51
$16.22
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.