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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | None (both parts) | $48.98 | $48.98 | $50.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $58.88 Median $75.86 Typical High $165.96 | Professional | None (both parts) | $58.88 | $75.86 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $52.48 Typical High $79.43 | Facility | None | $48.98 | $52.48 | $79.43 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.11 Median $47.86 Typical High $93.33 | Professional | None (both parts) | $33.11 | $47.86 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $51.29 Median $74.13 Typical High $169.82 | Professional | None (both parts) | $51.29 | $74.13 | $169.82 |
9 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 $24.55 Median $24.55 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.00 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $19.05 Typical High $37.15 | Professional | 26 · Professional part | $16.22 | $19.05 | $37.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $23.99 Typical High $67.61 | Professional | 51 · Multiple procedures | $16.60 | $23.99 | $67.61 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.61 Median $9.55 Typical High $26.92 | Professional | 80 · Assistant surgeon | $6.61 | $9.55 | $26.92 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.68 Median $6.61 Typical High $18.62 | Professional | 81 · Minimal assistant surgeon | $4.68 | $6.61 | $18.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.68 Median $6.61 Typical High $18.62 | Professional | 82 · Assistant surgeon, no resident | $4.68 | $6.61 | $18.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.68 Median $6.61 Typical High $18.62 | Professional | AS · PA/NP assist | $4.68 | $6.61 | $18.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $28.84 Typical High $54.95 | Professional | TC · Technical part | $24.55 | $28.84 | $54.95 |
Where North Carolina sits
The same service costs 6.9 times more in Alaska than in New York. 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
$75.86
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.