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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | None | $91.20 | $100.00 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $204.17 | Professional | None | $75.86 | $75.86 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $251.19 | Professional | None | $134.90 | $190.55 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Medcost Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $169.82 | Professional | None | $70.79 | $93.33 | $169.82 |
United Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $263.03 | Professional | None | $95.50 | $112.20 | $263.03 |
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 $35.48 Median $46.77 Typical High $138.04 | Professional | 51 · Multiple procedures | $35.48 | $46.77 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $18.62 Typical High $56.23 | Professional | 80 · Assistant surgeon | $14.13 | $18.62 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.00 Median $13.18 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $10.00 | $13.18 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.00 Median $13.18 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $10.00 | $13.18 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.00 Median $13.18 Typical High $38.90 | Professional | AS · PA/NP assist | $10.00 | $13.18 | $38.90 |
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
$191
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.