How much rates vary
Facilitymedian $72 · 10th to 90th $17 to $955Professionalmedian $158 · 10th to 90th $120 to $275
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $120.23 Median $1,000.00 Typical High $7,943.28 | Facility | None | $120.23 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None (both parts) | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 26 · Professional part | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | TC · Technical part | $13.49 | $13.49 | $16.22 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10.96 Median $16.98 Typical High $43.65 | Facility | None | $10.96 | $16.98 | $43.65 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $151.36 Median $239.88 Typical High $354.81 | Professional | 26 · Professional part | $151.36 | $239.88 | $354.81 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $22.39 Typical High $35.48 | Professional | TC · Technical part | $10.23 | $22.39 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $26.92 Typical High $56.23 | Facility | None | $16.98 | $26.92 | $56.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $144.54 Median $169.82 Typical High $316.23 | Professional | None (both parts) | $144.54 | $169.82 | $316.23 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $154.88 Typical High $288.40 | Professional | 26 · Professional part | $131.83 | $154.88 | $288.40 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $8.91 Median $15.14 Typical High $31.62 | Professional | TC · Technical part | $8.91 | $15.14 | $31.62 |
Medcost Setting Facility Modifier None Typical Low $12.02 Median $18.62 Typical High $120.23 | Facility | None | $12.02 | $18.62 | $120.23 |
Medcost Setting Professional Modifier None (both parts) Typical Low $131.83 Median $173.78 Typical High $234.42 | Professional | None (both parts) | $131.83 | $173.78 | $234.42 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $154.88 Typical High $177.83 | Professional | 26 · Professional part | $131.83 | $154.88 | $177.83 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $11.48 Median $15.14 Typical High $23.44 | Professional | TC · Technical part | $11.48 | $15.14 | $23.44 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None (both parts) Typical Low $114.82 Median $151.36 Typical High $295.12 | Professional | None (both parts) | $114.82 | $151.36 | $295.12 |
United Setting Professional Modifier 26 · Professional part Typical Low $107.15 Median $138.04 Typical High $263.03 | Professional | 26 · Professional part | $107.15 | $138.04 | $263.03 |
United Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $15.14 Typical High $34.67 | Professional | TC · Technical part | $10.23 | $15.14 | $34.67 |
11 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 $60.26 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $89.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $9.33 Median $9.33 Typical High $15.85 | Facility | 51 · Multiple procedures | $9.33 | $9.33 | $15.85 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $107.15 Typical High $173.78 | Professional | 51 · Multiple procedures | $81.28 | $107.15 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $42.66 Typical High $69.18 | Professional | 80 · Assistant surgeon | $32.36 | $42.66 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.39 Median $30.20 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $22.39 | $30.20 | $48.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.39 Median $30.20 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $22.39 | $30.20 | $48.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.39 Median $30.20 Typical High $48.98 | Professional | AS · PA/NP assist | $22.39 | $30.20 | $48.98 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska 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· 37th of 51
$145
AK $490AL $105
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.