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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $478.63 | $489.78 | $489.78 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $512.86 Median $676.08 Typical High $1,949.84 | Professional | None (both parts) | $512.86 | $676.08 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,754.23 | Facility | None | $891.25 | $1,584.89 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $724.44 | Facility | None | $489.78 | $489.78 | $724.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $1,047.13 | Professional | None (both parts) | $602.56 | $602.56 | $1,047.13 |
United Setting Professional Modifier None (both parts) Typical Low $257.04 Median $363.08 Typical High $630.96 | Professional | None (both parts) | $257.04 | $363.08 | $630.96 |
10 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 $239.88 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $97.72 | $112.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $245.47 Typical High $446.68 | Professional | 26 · Professional part | $245.47 | $245.47 | $446.68 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $912.01 Typical High $2,344.23 | Professional | 50 · Both sides | $912.01 | $912.01 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $302.00 Typical High $776.25 | Professional | 51 · Multiple procedures | $302.00 | $302.00 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $123.03 Typical High $309.03 | Professional | 80 · Assistant surgeon | $123.03 | $123.03 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $85.11 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $85.11 | $85.11 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $85.11 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $85.11 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $85.11 Typical High $218.78 | Professional | AS · PA/NP assist | $85.11 | $85.11 | $218.78 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $562.34 Median $562.34 Typical High $1,047.13 | Professional | TC · Technical part | $562.34 | $562.34 | $1,047.13 |
Where North Carolina sits
The same service costs 47.9 times more in Texas than in Alabama. 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· 13th of 51
$603
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.