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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $588.84 Median $602.56 Typical High $691.83 | Professional | None (both parts) | $588.84 | $602.56 | $691.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $645.65 Median $831.76 Typical High $2,398.83 | Professional | None (both parts) | $645.65 | $831.76 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,122.02 | $1,995.26 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $912.01 | Facility | None | $602.56 | $602.56 | $912.01 |
Medcost Setting Professional Modifier None (both parts) Typical Low $758.58 Median $758.58 Typical High $1,318.26 | Professional | None (both parts) | $758.58 | $758.58 | $1,318.26 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $776.25 | Professional | None (both parts) | $316.23 | $457.09 | $776.25 |
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 $295.12 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $141.25 | Professional | 53 · Discontinued | $117.49 | $120.23 | $141.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $302.00 Typical High $562.34 | Professional | 26 · Professional part | $302.00 | $302.00 | $562.34 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,148.15 Typical High $2,951.21 | Professional | 50 · Both sides | $1,148.15 | $1,148.15 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $380.19 Typical High $977.24 | Professional | 51 · Multiple procedures | $380.19 | $380.19 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $151.36 Typical High $389.05 | Professional | 80 · Assistant surgeon | $151.36 | $151.36 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $107.15 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $107.15 | $107.15 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $107.15 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $107.15 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $107.15 Typical High $275.42 | Professional | AS · PA/NP assist | $107.15 | $107.15 | $275.42 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $707.95 Median $707.95 Typical High $1,288.25 | Professional | TC · Technical part | $707.95 | $707.95 | $1,288.25 |
Where North Carolina sits
The same service costs 12.0 times more in Texas than in Ohio. 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
$759
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.