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 $25.70 Median $25.70 Typical High $28.18 | Facility | None | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $33.88 | Professional | None | $25.70 | $28.18 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $51.29 | Professional | None | $27.54 | $39.81 | $51.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $128.82 | Professional | None | $41.69 | $89.13 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $28.18 Typical High $33.11 | Facility | None | $25.70 | $28.18 | $33.11 |
Medcost Setting Professional Modifier None Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | None | $19.05 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $45.71 | Professional | None | $24.55 | $27.54 | $45.71 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $13.18 Typical High $14.13 | Professional | 52 · Reduced service | $12.88 | $13.18 | $14.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $9.55 Median $13.80 Typical High $13.80 | Professional | 51 · Multiple procedures | $9.55 | $13.80 | $13.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.80 Median $5.50 Typical High $5.50 | Professional | 80 · Assistant surgeon | $3.80 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.69 Median $3.89 Typical High $3.89 | Professional | 81 · Minimal assistant surgeon | $2.69 | $3.89 | $3.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.69 Median $3.89 Typical High $3.89 | Professional | 82 · Assistant surgeon, no resident | $2.69 | $3.89 | $3.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.69 Median $3.89 Typical High $3.89 | Professional | AS · PA/NP assist | $2.69 | $3.89 | $3.89 |
Where North Carolina sits
The same service costs 3.0 times more in North Carolina 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· 1st of 51
$72.44
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.