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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,548.82 Typical High $1,862.09 | Professional | None (both parts) | $1,513.56 | $1,548.82 | $1,862.09 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,137.96 Typical High $6,165.95 | Professional | None (both parts) | $1,659.59 | $2,137.96 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $5,128.61 Typical High $8,912.51 | Facility | None | $2,884.03 | $5,128.61 | $8,912.51 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,290.87 | Facility | None | $1,548.82 | $1,548.82 | $2,290.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $1,949.84 Typical High $3,467.37 | Professional | None (both parts) | $1,949.84 | $1,949.84 | $3,467.37 |
United Setting Professional Modifier None (both parts) Typical Low $812.83 Median $1,174.90 Typical High $2,137.96 | Professional | None (both parts) | $812.83 | $1,174.90 | $2,137.96 |
11 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 26 · Professional part Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 26 · Professional part | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $776.25 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $309.03 | $371.54 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $776.25 Median $776.25 Typical High $1,445.44 | Professional | 26 · Professional part | $776.25 | $776.25 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $2,884.03 Typical High $7,413.10 | Professional | 50 · Both sides | $2,884.03 | $2,884.03 | $7,413.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $977.24 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $389.05 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $389.05 | $389.05 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $269.15 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $269.15 | $269.15 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $269.15 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $269.15 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $269.15 Typical High $691.83 | Professional | AS · PA/NP assist | $269.15 | $269.15 | $691.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,819.70 Median $1,819.70 Typical High $3,311.31 | Professional | TC · Technical part | $1,819.70 | $1,819.70 | $3,311.31 |
Where North Carolina sits
The same service costs 12.0 times more in Texas 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· 20th of 51
$1,950
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.