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 $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4,073.80 Median $4,168.69 Typical High $4,570.88 | Professional | None (both parts) | $4,073.80 | $4,168.69 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $5,754.40 Typical High $16,595.87 | Professional | None (both parts) | $4,466.84 | $5,754.40 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $13,803.84 Typical High $23,988.33 | Facility | None | $7,762.47 | $13,803.84 | $23,988.33 |
Medcost Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $6,165.95 | Facility | None | $4,168.69 | $4,168.69 | $6,165.95 |
Medcost Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $5,248.07 Typical High $8,912.51 | Professional | None (both parts) | $5,248.07 | $5,248.07 | $8,912.51 |
United Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $3,162.28 Typical High $5,370.32 | Professional | None (both parts) | $2,187.76 | $3,162.28 | $5,370.32 |
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 $2,041.74 Median $2,089.30 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,041.74 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $831.76 Typical High $1,000.00 | Professional | 53 · Discontinued | $812.83 | $831.76 | $1,000.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $2,089.30 Median $2,089.30 Typical High $3,890.45 | Professional | 26 · Professional part | $2,089.30 | $2,089.30 | $3,890.45 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $7,762.47 Median $7,762.47 Typical High $19,952.62 | Professional | 50 · Both sides | $7,762.47 | $7,762.47 | $19,952.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,630.27 Median $2,630.27 Typical High $6,760.83 | Professional | 51 · Multiple procedures | $2,630.27 | $2,630.27 | $6,760.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,047.13 Median $1,047.13 Typical High $2,691.53 | Professional | 80 · Assistant surgeon | $1,047.13 | $1,047.13 | $2,691.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $724.44 Median $724.44 Typical High $1,862.09 | Professional | 81 · Minimal assistant surgeon | $724.44 | $724.44 | $1,862.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $724.44 Median $724.44 Typical High $1,862.09 | Professional | 82 · Assistant surgeon, no resident | $724.44 | $724.44 | $1,862.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $724.44 Median $724.44 Typical High $1,862.09 | Professional | AS · PA/NP assist | $724.44 | $724.44 | $1,862.09 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $4,786.30 Median $4,786.30 Typical High $8,912.51 | Professional | TC · Technical part | $4,786.30 | $4,786.30 | $8,912.51 |
Where North Carolina sits
The same service costs 416.9 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
$5,248
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.