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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | None (both parts) | $1,047.13 | $1,071.52 | $1,174.90 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,479.11 Typical High $4,265.80 | Professional | None (both parts) | $1,148.15 | $1,479.11 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,025.60 | Facility | None | $1,949.84 | $3,548.13 | $6,025.60 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Facility | None | $1,071.52 | $1,071.52 | $1,584.89 |
Medcost Setting Professional Modifier None (both parts) Typical Low $1,348.96 Median $1,348.96 Typical High $2,290.87 | Professional | None (both parts) | $1,348.96 | $1,348.96 | $2,290.87 |
United Setting Professional Modifier None (both parts) Typical Low $562.34 Median $794.33 Typical High $1,380.38 | Professional | None (both parts) | $562.34 | $794.33 | $1,380.38 |
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 $524.81 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $213.80 | $251.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $537.03 Median $537.03 Typical High $1,000.00 | Professional | 26 · Professional part | $537.03 | $537.03 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $1,995.26 Typical High $5,128.61 | Professional | 50 · Both sides | $1,995.26 | $1,995.26 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $660.69 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $660.69 | $660.69 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $269.15 Typical High $691.83 | Professional | 80 · Assistant surgeon | $269.15 | $269.15 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $186.21 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $186.21 | $186.21 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $186.21 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $186.21 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $186.21 Typical High $478.63 | Professional | AS · PA/NP assist | $186.21 | $186.21 | $478.63 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,230.27 Median $1,230.27 Typical High $2,290.87 | Professional | TC · Technical part | $1,230.27 | $1,230.27 | $2,290.87 |
Where North Carolina sits
The same service costs 104.7 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· 15th of 51
$1,349
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.