How much rates vary
Facilitymedian $72 · 10th to 90th $72 to $7,943Professionalmedian $72 · 10th to 90th $71 to $115
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 Professional Modifier 26 · Professional part Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 26 · Professional part | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | TC · Technical part | $43.65 | $43.65 | $43.65 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $38.02 Typical High $93.33 | Professional | 26 · Professional part | $27.54 | $38.02 | $93.33 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $58.88 Typical High $141.25 | Professional | TC · Technical part | $42.66 | $58.88 | $141.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 26 · Professional part | $23.99 | $28.18 | $28.18 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | TC · Technical part | $36.31 | $42.66 | $42.66 |
United Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $38.90 Typical High $77.62 | Professional | 26 · Professional part | $28.18 | $38.90 | $77.62 |
United Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $58.88 Typical High $100.00 | Professional | TC · Technical part | $41.69 | $58.88 | $100.00 |
13 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 Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $7,943.28 | Facility | None | $72.44 | $72.44 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 54 · Surgery only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None (both parts) | $75.86 | $75.86 | $79.43 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $354.81 | Professional | None (both parts) | $100.00 | $100.00 | $354.81 |
Medcost Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $50.12 | $70.79 | $70.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $24.55 Median $35.48 Typical High $35.48 | Professional | 51 · Multiple procedures | $24.55 | $35.48 | $35.48 |
United Setting Professional Modifier None (both parts) Typical Low $70.79 Median $97.72 Typical High $173.78 | Professional | None (both parts) | $70.79 | $97.72 | $173.78 |
Where North Carolina sits
The same service costs 4.4 times more in Texas 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· 34th of 51
$72.44
TX $174NY $39.81
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.