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 $22.91 Median $22.91 Typical High $25.70 | Facility | None | $22.91 | $22.91 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $25.70 | Professional | None | $22.91 | $24.55 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $36.31 | Professional | None | $20.42 | $26.92 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | None | $31.62 | $31.62 | $36.31 |
Medcost Setting Facility Modifier None Typical Low $22.91 Median $25.70 Typical High $30.20 | Facility | None | $22.91 | $25.70 | $30.20 |
Medcost Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | None | $17.38 | $17.38 | $24.55 |
United Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $61.66 | Professional | None | $22.39 | $26.92 | $61.66 |
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 $11.48 Median $12.02 Typical High $12.88 | Professional | 52 · Reduced service | $11.48 | $12.02 | $12.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $8.51 Median $8.71 Typical High $12.30 | Professional | 51 · Multiple procedures | $8.51 | $8.71 | $12.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $3.47 Median $3.47 Typical High $4.90 | Professional | 80 · Assistant surgeon | $3.47 | $3.47 | $4.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | 81 · Minimal assistant surgeon | $2.40 | $2.40 | $3.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | 82 · Assistant surgeon, no resident | $2.40 | $2.40 | $3.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | AS · PA/NP assist | $2.40 | $2.40 | $3.47 |
Where North Carolina sits
The same service costs 2.8 times more in North Dakota than in New Mexico. 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· 25th of 51
$26.30
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.