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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $3,981.07 Typical High $4,786.30 | Professional | None (both parts) | $3,890.45 | $3,981.07 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $4,265.80 Median $5,495.41 Typical High $15,848.93 | Professional | None (both parts) | $4,265.80 | $5,495.41 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $15,135.61 Typical High $22,908.68 | Facility | None | $7,413.10 | $15,135.61 | $22,908.68 |
Medcost Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,981.07 | $3,981.07 | $5,888.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5,011.87 Median $5,011.87 Typical High $8,511.38 | Professional | None (both parts) | $5,011.87 | $5,011.87 | $8,511.38 |
United Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $3,019.95 Typical High $5,128.61 | Professional | None (both parts) | $2,089.30 | $3,019.95 | $5,128.61 |
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 $1,949.84 Median $1,995.26 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $794.33 Typical High $954.99 | Professional | 53 · Discontinued | $776.25 | $794.33 | $954.99 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,995.26 Median $1,995.26 Typical High $3,715.35 | Professional | 26 · Professional part | $1,995.26 | $1,995.26 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7,585.78 Median $7,585.78 Typical High $19,054.61 | Professional | 50 · Both sides | $7,585.78 | $7,585.78 | $19,054.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,511.89 Median $2,511.89 Typical High $6,456.54 | Professional | 51 · Multiple procedures | $2,511.89 | $2,511.89 | $6,456.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,000.00 Median $1,000.00 Typical High $2,570.40 | Professional | 80 · Assistant surgeon | $1,000.00 | $1,000.00 | $2,570.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $707.95 Median $707.95 Typical High $1,819.70 | Professional | 81 · Minimal assistant surgeon | $707.95 | $707.95 | $1,819.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $707.95 Median $707.95 Typical High $1,819.70 | Professional | 82 · Assistant surgeon, no resident | $707.95 | $707.95 | $1,819.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $707.95 Median $707.95 Typical High $1,819.70 | Professional | AS · PA/NP assist | $707.95 | $707.95 | $1,819.70 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,677.35 Median $4,677.35 Typical High $8,511.38 | Professional | TC · Technical part | $4,677.35 | $4,677.35 | $8,511.38 |
Where North Carolina sits
The same service costs 12.0 times more in Texas than in Alabama. 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· 21st of 51
$5,012
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.