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 $9.12 Median $9.12 Typical High $18.20 | Facility | None | $9.12 | $9.12 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $14.79 Typical High $18.62 | Professional | None | $9.12 | $14.79 | $18.62 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $19.05 Typical High $19.50 | Professional | None | $13.49 | $19.05 | $19.50 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.76 Median $17.78 Typical High $39.81 | Professional | None | $7.76 | $17.78 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medcost Setting Facility Modifier None Typical Low $9.12 Median $11.75 Typical High $20.89 | Facility | None | $9.12 | $11.75 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | None | $16.22 | $17.38 | $17.38 |
Oscar Health Setting Professional Modifier None Typical Low $8.51 Median $19.05 Typical High $40.74 | Professional | None | $8.51 | $19.05 | $40.74 |
United Setting Professional Modifier None Typical Low $8.91 Median $16.22 Typical High $23.99 | Professional | None | $8.91 | $16.22 | $23.99 |
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 52 · Reduced service Typical Low $4.57 Median $5.50 Typical High $9.12 | Professional | 52 · Reduced service | $4.57 | $5.50 | $9.12 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | 59 · Distinct service | $15.14 | $17.78 | $17.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.17 Median $8.71 Typical High $8.71 | Professional | 51 · Multiple procedures | $6.17 | $8.71 | $8.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.45 Median $3.47 Typical High $3.47 | Professional | 80 · Assistant surgeon | $2.45 | $3.47 | $3.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.74 Median $2.45 Typical High $2.45 | Professional | 81 · Minimal assistant surgeon | $1.74 | $2.45 | $2.45 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.74 Median $2.45 Typical High $2.45 | Professional | 82 · Assistant surgeon, no resident | $1.74 | $2.45 | $2.45 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.74 Median $2.45 Typical High $2.45 | Professional | AS · PA/NP assist | $1.74 | $2.45 | $2.45 |
Where North Carolina sits
The same service costs 2.3 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· 15th of 51
$17.38
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.