How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | None | $12.59 | $12.88 | $12.88 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5.75 Median $6.61 Typical High $20.89 | Facility | None | $5.75 | $6.61 | $20.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $95.50 | Professional | None | $67.61 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $302.00 | Facility | None | $144.54 | $213.80 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $12.88 Median $16.60 Typical High $141.25 | Facility | None | $12.88 | $16.60 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $19.95 | Professional | None | $4.37 | $4.37 | $19.95 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $2.19 Median $2.19 Typical High $16.22 | Professional | 51 · Multiple procedures | $2.19 | $2.19 | $16.22 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $0.87 Median $0.87 Typical High $6.46 | Professional | 80 · Assistant surgeon | $0.87 | $0.87 | $6.46 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $0.62 Median $0.62 Typical High $4.47 | Professional | 81 · Minimal assistant surgeon | $0.62 | $0.62 | $4.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $0.62 Median $0.62 Typical High $4.47 | Professional | 82 · Assistant surgeon, no resident | $0.62 | $0.62 | $4.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $0.62 Median $0.62 Typical High $4.47 | Professional | AS · PA/NP assist | $0.62 | $0.62 | $4.47 |
Where North Carolina sits
The same service costs 10.0 times more in Oregon than in Virginia. 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
$89.13
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.