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 $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $3,311.31 Typical High $3,890.45 | Professional | None (both parts) | $3,235.94 | $3,311.31 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,548.13 Median $4,570.88 Typical High $13,182.57 | Professional | None (both parts) | $3,548.13 | $4,570.88 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $6,165.95 Median $12,882.50 Typical High $19,054.61 | Facility | None | $6,165.95 | $12,882.50 | $19,054.61 |
Medcost Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $5,011.87 | Facility | None | $3,311.31 | $3,311.31 | $5,011.87 |
Medcost Setting Professional Modifier None (both parts) Typical Low $4,168.69 Median $4,168.69 Typical High $7,244.36 | Professional | None (both parts) | $4,168.69 | $4,168.69 | $7,244.36 |
United Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,511.89 Typical High $4,265.80 | Professional | None (both parts) | $1,737.80 | $2,511.89 | $4,265.80 |
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 $1,621.81 Median $1,659.59 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,621.81 | $1,659.59 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $776.25 | Professional | 53 · Discontinued | $645.65 | $676.08 | $776.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,659.59 Median $1,659.59 Typical High $3,090.30 | Professional | 26 · Professional part | $1,659.59 | $1,659.59 | $3,090.30 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,309.57 Median $6,309.57 Typical High $16,218.10 | Professional | 50 · Both sides | $6,309.57 | $6,309.57 | $16,218.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,089.30 Median $2,089.30 Typical High $5,370.32 | Professional | 51 · Multiple procedures | $2,089.30 | $2,089.30 | $5,370.32 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $831.76 Median $831.76 Typical High $2,137.96 | Professional | 80 · Assistant surgeon | $831.76 | $831.76 | $2,137.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $588.84 Typical High $1,513.56 | Professional | 81 · Minimal assistant surgeon | $588.84 | $588.84 | $1,513.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $588.84 Typical High $1,513.56 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $588.84 | $1,513.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $588.84 Typical High $1,513.56 | Professional | AS · PA/NP assist | $588.84 | $588.84 | $1,513.56 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,890.45 Median $3,890.45 Typical High $7,244.36 | Professional | TC · Technical part | $3,890.45 | $3,890.45 | $7,244.36 |
Where North Carolina sits
The same service costs 67.6 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
$4,169
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.