How much rates vary
Facilitymedian $42 · 10th to 90th $28 to $135Professionalmedian $39 · 10th to 90th $28 to $74
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 TC · Technical part Typical Low $19.50 Median $22.39 Typical High $35.48 | Facility | TC · Technical part | $19.50 | $22.39 | $35.48 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $8.51 Median $8.71 Typical High $18.20 | Professional | 26 · Professional part | $8.51 | $8.71 | $18.20 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $19.50 Typical High $41.69 | Professional | TC · Technical part | $18.62 | $19.50 | $41.69 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $22.39 Typical High $28.18 | Professional | 26 · Professional part | $15.49 | $22.39 | $28.18 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $35.48 Median $42.66 Typical High $58.88 | Professional | TC · Technical part | $35.48 | $42.66 | $58.88 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $9.12 Median $12.59 Typical High $25.70 | Professional | 26 · Professional part | $9.12 | $12.59 | $25.70 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $26.92 Typical High $56.23 | Professional | TC · Technical part | $20.42 | $26.92 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $15.85 Typical High $23.44 | Professional | 26 · Professional part | $12.30 | $15.85 | $23.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $36.31 Typical High $41.69 | Professional | TC · Technical part | $25.12 | $36.31 | $41.69 |
United Setting Professional Modifier 26 · Professional part Typical Low $9.33 Median $12.02 Typical High $20.89 | Professional | 26 · Professional part | $9.33 | $12.02 | $20.89 |
United Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $25.70 Typical High $45.71 | Professional | TC · Technical part | $19.05 | $25.70 | $45.71 |
19 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 $28.18 Median $28.18 Typical High $46.77 | Facility | None | $28.18 | $28.18 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $28.18 Typical High $58.88 | Professional | None (both parts) | $27.54 | $28.18 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.13 Typical High $16.22 | Professional | 52 · Reduced service | $13.18 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.62 Typical High $6.46 | Professional | 53 · Discontinued | $5.25 | $5.62 | $6.46 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | FX · Film X-ray | $21.88 | $22.39 | $22.39 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None (both parts) | $41.69 | $41.69 | $41.69 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None (both parts) | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $87.10 Typical High $134.90 | Facility | None | $33.88 | $87.10 | $134.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $40.74 Typical High $81.28 | Professional | None (both parts) | $30.20 | $40.74 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Medcost Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $35.48 | Facility | None | $28.18 | $28.18 | $35.48 |
Medcost Setting Professional Modifier None (both parts) Typical Low $34.67 Median $51.29 Typical High $72.44 | Professional | None (both parts) | $34.67 | $51.29 | $72.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $19.95 Median $26.30 Typical High $42.66 | Professional | 51 · Multiple procedures | $19.95 | $26.30 | $42.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.94 Median $10.72 Typical High $16.98 | Professional | 80 · Assistant surgeon | $7.94 | $10.72 | $16.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.62 Median $7.41 Typical High $12.02 | Professional | 81 · Minimal assistant surgeon | $5.62 | $7.41 | $12.02 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.62 Median $7.41 Typical High $12.02 | Professional | 82 · Assistant surgeon, no resident | $5.62 | $7.41 | $12.02 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.62 Median $7.41 Typical High $12.02 | Professional | AS · PA/NP assist | $5.62 | $7.41 | $12.02 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None (both parts) | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $38.02 Typical High $66.07 | Professional | None (both parts) | $28.84 | $38.02 | $66.07 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 26th of 51
$38.90
AK $95.50FL $25.12
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.