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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | None (both parts) | $281.84 | $288.40 | $338.84 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $309.03 Median $398.11 Typical High $1,148.15 | Professional | None (both parts) | $309.03 | $398.11 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,096.48 Typical High $1,659.59 | Facility | None | $537.03 | $1,096.48 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $426.58 | Facility | None | $288.40 | $288.40 | $426.58 |
Medcost Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $616.60 | Professional | None (both parts) | $363.08 | $363.08 | $616.60 |
United Setting Professional Modifier None (both parts) Typical Low $151.36 Median $218.78 Typical High $371.54 | Professional | None (both parts) | $151.36 | $218.78 | $371.54 |
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 $141.25 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $57.54 | $69.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $144.54 Median $144.54 Typical High $269.15 | Professional | 26 · Professional part | $144.54 | $144.54 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $537.03 Typical High $1,380.38 | Professional | 50 · Both sides | $537.03 | $537.03 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $181.97 Typical High $467.74 | Professional | 51 · Multiple procedures | $181.97 | $181.97 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $72.44 Typical High $186.21 | Professional | 80 · Assistant surgeon | $72.44 | $72.44 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $50.12 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $50.12 | $50.12 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $50.12 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $50.12 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $50.12 Typical High $128.82 | Professional | AS · PA/NP assist | $50.12 | $50.12 | $128.82 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $331.13 Median $331.13 Typical High $616.60 | Professional | TC · Technical part | $331.13 | $331.13 | $616.60 |
Where North Carolina sits
The same service costs 12.0 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· 11th of 51
$363
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.