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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | None | $5.75 | $5.75 | $7.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $28.84 | Professional | None | $6.46 | $9.77 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $7.76 | Facility | None | $5.75 | $5.75 | $7.76 |
Medcost Setting Professional Modifier None Typical Low $4.17 Median $10.00 Typical High $12.59 | Professional | None | $4.17 | $10.00 | $12.59 |
Oscar Health Setting Professional Modifier None Typical Low $6.76 Median $12.88 Typical High $15.85 | Professional | None | $6.76 | $12.88 | $15.85 |
United Setting Professional Modifier None Typical Low $7.41 Median $12.59 Typical High $17.38 | Professional | None | $7.41 | $12.59 | $17.38 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2.09 Median $5.01 Typical High $6.31 | Professional | 51 · Multiple procedures | $2.09 | $5.01 | $6.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.83 Median $2.00 Typical High $2.51 | Professional | 80 · Assistant surgeon | $0.83 | $2.00 | $2.51 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.58 Median $1.38 Typical High $1.74 | Professional | 81 · Minimal assistant surgeon | $0.58 | $1.38 | $1.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.58 Median $1.38 Typical High $1.74 | Professional | 82 · Assistant surgeon, no resident | $0.58 | $1.38 | $1.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.58 Median $1.38 Typical High $1.74 | Professional | AS · PA/NP assist | $0.58 | $1.38 | $1.74 |
Where North Carolina sits
The same service costs 3.2 times more in Massachusetts 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· 24th of 51
$9.77
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.