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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $2,884.03 Typical High $3,311.31 | Professional | None (both parts) | $2,818.38 | $2,884.03 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $3,981.07 Typical High $11,481.54 | Professional | None (both parts) | $3,090.30 | $3,981.07 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $9,549.93 Typical High $16,218.10 | Facility | None | $5,248.07 | $9,549.93 | $16,218.10 |
Medcost Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,265.80 | Facility | None | $2,884.03 | $2,884.03 | $4,265.80 |
Medcost Setting Professional Modifier None (both parts) Typical Low $3,630.78 Median $3,630.78 Typical High $6,165.95 | Professional | None (both parts) | $3,630.78 | $3,630.78 | $6,165.95 |
United Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $2,137.96 Typical High $3,715.35 | Professional | None (both parts) | $1,513.56 | $2,137.96 | $3,715.35 |
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 $1,412.54 Median $1,445.44 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $660.69 | Professional | 53 · Discontinued | $562.34 | $575.44 | $660.69 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,445.44 Median $1,445.44 Typical High $2,691.53 | Professional | 26 · Professional part | $1,445.44 | $1,445.44 | $2,691.53 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,370.32 Median $5,370.32 Typical High $13,803.84 | Professional | 50 · Both sides | $5,370.32 | $5,370.32 | $13,803.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,819.70 Median $1,819.70 Typical High $4,677.35 | Professional | 51 · Multiple procedures | $1,819.70 | $1,819.70 | $4,677.35 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $724.44 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $724.44 | $724.44 | $1,862.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | 81 · Minimal assistant surgeon | $501.19 | $501.19 | $1,288.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | 82 · Assistant surgeon, no resident | $501.19 | $501.19 | $1,288.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | AS · PA/NP assist | $501.19 | $501.19 | $1,288.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $3,311.31 Median $3,311.31 Typical High $6,165.95 | Professional | TC · Technical part | $3,311.31 | $3,311.31 | $6,165.95 |
Where North Carolina sits
The same service costs 8.9 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· 14th of 51
$3,631
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.