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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $1,659.59 | $1,698.24 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,344.23 Typical High $6,760.83 | Professional | None (both parts) | $1,819.70 | $2,344.23 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $5,623.41 Typical High $9,772.37 | Facility | None | $3,162.28 | $5,623.41 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,511.89 | Facility | None | $1,698.24 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $3,630.78 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $3,630.78 |
United Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,288.25 Typical High $2,187.76 | Professional | None (both parts) | $891.25 | $1,288.25 | $2,187.76 |
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 $831.76 Median $851.14 Typical High $977.24 | Professional | 52 · Reduced service | $831.76 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $338.84 | $389.05 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $851.14 Median $851.14 Typical High $1,584.89 | Professional | 26 · Professional part | $851.14 | $851.14 | $1,584.89 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,162.28 Typical High $8,128.31 | Professional | 50 · Both sides | $3,162.28 | $3,162.28 | $8,128.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,071.52 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $1,071.52 | $1,071.52 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $426.58 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $426.58 | $426.58 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $295.12 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $295.12 | $295.12 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $295.12 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $295.12 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $295.12 Typical High $758.58 | Professional | AS · PA/NP assist | $295.12 | $295.12 | $758.58 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,949.84 Median $1,949.84 Typical High $3,630.78 | Professional | TC · Technical part | $1,949.84 | $1,949.84 | $3,630.78 |
Where North Carolina sits
The same service costs 229.1 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
$2,138
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.