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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $204.17 Median $208.93 Typical High $245.47 | Professional | None (both parts) | $204.17 | $208.93 | $245.47 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $223.87 Median $288.40 Typical High $831.76 | Professional | None (both parts) | $223.87 | $288.40 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $1,174.90 | Facility | None | $380.19 | $691.83 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $309.03 | Facility | None | $208.93 | $208.93 | $309.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $446.68 | Professional | None (both parts) | $263.03 | $263.03 | $446.68 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $154.88 Typical High $269.15 | Professional | None (both parts) | $109.65 | $154.88 | $269.15 |
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 $102.33 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $41.69 | $48.98 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $104.71 Median $104.71 Typical High $194.98 | Professional | 26 · Professional part | $104.71 | $104.71 | $194.98 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $389.05 Typical High $1,000.00 | Professional | 50 · Both sides | $389.05 | $389.05 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $128.82 Typical High $331.13 | Professional | 51 · Multiple procedures | $128.82 | $128.82 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $52.48 Typical High $134.90 | Professional | 80 · Assistant surgeon | $52.48 | $52.48 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $36.31 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $36.31 | $36.31 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $36.31 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $36.31 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $36.31 Typical High $93.33 | Professional | AS · PA/NP assist | $36.31 | $36.31 | $93.33 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $239.88 Median $239.88 Typical High $446.68 | Professional | TC · Technical part | $239.88 | $239.88 | $446.68 |
Where North Carolina sits
The same service costs 5.4 times more in Alaska 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· 18th of 51
$263
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.