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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,137.96 Typical High $2,454.71 | Professional | None (both parts) | $2,089.30 | $2,137.96 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $2,884.03 Typical High $8,317.64 | Professional | None (both parts) | $2,238.72 | $2,884.03 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $12,022.64 | Facility | None | $3,890.45 | $8,128.31 | $12,022.64 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,162.28 | Facility | None | $2,137.96 | $2,137.96 | $3,162.28 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $4,570.88 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $4,570.88 |
United Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,584.89 Typical High $2,754.23 | Professional | None (both parts) | $1,122.02 | $1,584.89 | $2,754.23 |
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 $1,023.29 Median $1,071.52 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $426.58 | $489.78 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,071.52 Median $1,071.52 Typical High $1,949.84 | Professional | 26 · Professional part | $1,071.52 | $1,071.52 | $1,949.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $3,981.07 Typical High $10,232.93 | Professional | 50 · Both sides | $3,981.07 | $3,981.07 | $10,232.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,318.26 Typical High $3,388.44 | Professional | 51 · Multiple procedures | $1,318.26 | $1,318.26 | $3,388.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $524.81 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $524.81 | $524.81 | $1,348.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $371.54 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $371.54 | $371.54 | $954.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $371.54 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $371.54 | $954.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $371.54 Typical High $954.99 | Professional | AS · PA/NP assist | $371.54 | $371.54 | $954.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,454.71 Median $2,454.71 Typical High $4,570.88 | Professional | TC · Technical part | $2,454.71 | $2,454.71 | $4,570.88 |
Where North Carolina sits
The same service costs 33.9 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
$2,630
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.