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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,290.87 Median $2,344.23 Typical High $2,691.53 | Professional | None (both parts) | $2,290.87 | $2,344.23 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,235.94 Typical High $9,332.54 | Professional | None (both parts) | $2,454.71 | $3,235.94 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $8,912.51 Typical High $13,182.57 | Facility | None | $4,265.80 | $8,912.51 | $13,182.57 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,467.37 | Facility | None | $2,344.23 | $2,344.23 | $3,467.37 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,951.21 Median $2,951.21 Typical High $5,011.87 | Professional | None (both parts) | $2,951.21 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,737.80 Typical High $3,019.95 | Professional | None (both parts) | $1,230.27 | $1,737.80 | $3,019.95 |
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 $1,148.15 Median $1,174.90 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $537.03 | Professional | 53 · Discontinued | $457.09 | $467.74 | $537.03 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,174.90 Median $1,174.90 Typical High $2,137.96 | Professional | 26 · Professional part | $1,174.90 | $1,174.90 | $2,137.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,365.16 Median $4,365.16 Typical High $11,220.18 | Professional | 50 · Both sides | $4,365.16 | $4,365.16 | $11,220.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,445.44 Typical High $3,715.35 | Professional | 51 · Multiple procedures | $1,445.44 | $1,445.44 | $3,715.35 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $588.84 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $588.84 | $588.84 | $1,513.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $407.38 Typical High $1,047.13 | Professional | 81 · Minimal assistant surgeon | $407.38 | $407.38 | $1,047.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $407.38 Typical High $1,047.13 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $407.38 | $1,047.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $407.38 Typical High $1,047.13 | Professional | AS · PA/NP assist | $407.38 | $407.38 | $1,047.13 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,691.53 Median $2,691.53 Typical High $5,011.87 | Professional | TC · Technical part | $2,691.53 | $2,691.53 | $5,011.87 |
Where North Carolina sits
The same service costs 37.2 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· 14th of 51
$2,951
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.