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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,995.26 Median $2,041.74 Typical High $2,238.72 | Professional | None (both parts) | $1,995.26 | $2,041.74 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $2,187.76 Median $2,818.38 Typical High $8,128.31 | Professional | None (both parts) | $2,187.76 | $2,818.38 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $3,801.89 Median $6,760.83 Typical High $11,748.98 | Facility | None | $3,801.89 | $6,760.83 | $11,748.98 |
Medcost Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,090.30 | Facility | None | $2,041.74 | $2,041.74 | $3,090.30 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $2,570.40 Typical High $4,466.84 | Professional | None (both parts) | $2,570.40 | $2,570.40 | $4,466.84 |
United Setting Professional Modifier None (both parts) Typical Low $1,071.52 Median $1,548.82 Typical High $2,630.27 | Professional | None (both parts) | $1,071.52 | $1,548.82 | $2,630.27 |
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 $1,000.00 Median $1,023.29 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $489.78 | Professional | 53 · Discontinued | $398.11 | $407.38 | $489.78 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,023.29 Median $1,023.29 Typical High $1,905.46 | Professional | 26 · Professional part | $1,023.29 | $1,023.29 | $1,905.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,890.45 Median $3,890.45 Typical High $10,000.00 | Professional | 50 · Both sides | $3,890.45 | $3,890.45 | $10,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,288.25 Typical High $3,311.31 | Professional | 51 · Multiple procedures | $1,288.25 | $1,288.25 | $3,311.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $512.86 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $512.86 | $512.86 | $1,318.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $363.08 Typical High $933.25 | Professional | 81 · Minimal assistant surgeon | $363.08 | $363.08 | $933.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $363.08 Typical High $933.25 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $363.08 | $933.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $363.08 Typical High $933.25 | Professional | AS · PA/NP assist | $363.08 | $363.08 | $933.25 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $2,398.83 Median $2,398.83 Typical High $4,365.16 | Professional | TC · Technical part | $2,398.83 | $2,398.83 | $4,365.16 |
Where North Carolina sits
The same service costs 204.2 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· 18th of 51
$2,570
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.