How much rates vary
Facilitymedian $56 · 10th to 90th $56 to $295Professionalmedian $158 · 10th to 90th $56 to $245
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 $20.42 Median $20.42 Typical High $32.36 | Professional | 26 · Professional part | $20.42 | $20.42 | $32.36 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | TC · Technical part | $36.31 | $36.31 | $58.88 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 26 · Professional part | $42.66 | $42.66 | $42.66 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $69.18 Typical High $97.72 | Professional | 26 · Professional part | $41.69 | $69.18 | $97.72 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $75.86 Median $117.49 Typical High $186.21 | Professional | TC · Technical part | $75.86 | $117.49 | $186.21 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $38.90 Typical High $67.61 | Professional | 26 · Professional part | $33.88 | $38.90 | $67.61 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $61.66 Median $102.33 Typical High $131.83 | Professional | TC · Technical part | $61.66 | $102.33 | $131.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 26 · Professional part | $60.26 | $61.66 | $61.66 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $51.29 Typical High $57.54 | Professional | 26 · Professional part | $26.92 | $51.29 | $57.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $91.20 Typical High $104.71 | Professional | TC · Technical part | $47.86 | $91.20 | $104.71 |
United Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $36.31 Typical High $52.48 | Professional | 26 · Professional part | $28.84 | $36.31 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $141.25 Typical High $245.47 | Professional | TC · Technical part | $114.82 | $141.25 | $245.47 |
17 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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | None (both parts) | $56.23 | $56.23 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | 53 · Discontinued | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | FX · Film X-ray | $45.71 | $45.71 | $52.48 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | None (both parts) | $70.79 | $70.79 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $97.72 Median $162.18 Typical High $190.55 | Professional | None (both parts) | $97.72 | $162.18 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $630.96 | Facility | None | $56.23 | $67.61 | $630.96 |
Medcost Setting Professional Modifier None (both parts) Typical Low $61.66 Median $144.54 Typical High $257.04 | Professional | None (both parts) | $61.66 | $144.54 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $30.90 Median $85.11 Typical High $128.82 | Professional | 51 · Multiple procedures | $30.90 | $85.11 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $33.88 Typical High $51.29 | Professional | 80 · Assistant surgeon | $12.30 | $33.88 | $51.29 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.51 Median $23.99 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $8.51 | $23.99 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.51 Median $23.99 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $8.51 | $23.99 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.51 Median $23.99 Typical High $35.48 | Professional | AS · PA/NP assist | $8.51 | $23.99 | $35.48 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | None (both parts) | $194.98 | $194.98 | $208.93 |
United Setting Professional Modifier None (both parts) Typical Low $147.91 Median $173.78 Typical High $309.03 | Professional | None (both parts) | $147.91 | $173.78 | $309.03 |
Where North Carolina sits
The same service costs 6.6 times more in Nebraska 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· 14th of 51
$158
NE $363FL $54.95
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.