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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $104.71 | $107.15 | $107.15 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $114.82 Median $147.91 Typical High $426.58 | Professional | None (both parts) | $114.82 | $147.91 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $616.60 | Facility | None | $199.53 | $354.81 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $158.49 | Facility | None | $107.15 | $107.15 | $158.49 |
Medcost Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $229.09 | Professional | None (both parts) | $134.90 | $134.90 | $229.09 |
United Setting Professional Modifier None (both parts) Typical Low $56.23 Median $81.28 Typical High $138.04 | Professional | None (both parts) | $56.23 | $81.28 | $138.04 |
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 $52.48 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $52.48 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $20.89 | $21.38 | $24.55 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $53.70 Typical High $100.00 | Professional | 26 · Professional part | $53.70 | $53.70 | $100.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $199.53 Typical High $512.86 | Professional | 50 · Both sides | $199.53 | $199.53 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $67.61 Median $67.61 Typical High $173.78 | Professional | 51 · Multiple procedures | $67.61 | $67.61 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $26.92 Typical High $69.18 | Professional | 80 · Assistant surgeon | $26.92 | $26.92 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $18.62 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $18.62 | $18.62 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $18.62 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $18.62 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $18.62 Typical High $47.86 | Professional | AS · PA/NP assist | $18.62 | $18.62 | $47.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $123.03 Typical High $229.09 | Professional | TC · Technical part | $123.03 | $123.03 | $229.09 |
Where North Carolina sits
The same service costs 11.7 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· 25th of 51
$135
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.