How much rates vary
Facilitymedian $155 · 10th to 90th $87 to $490Professionalmedian $117 · 10th to 90th $45 to $204
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 $117.49 Median $117.49 Typical High $147.91 | Facility | None | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $117.49 Typical High $218.78 | Professional | None (both parts) | $87.10 | $117.49 | $218.78 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $30.20 Typical High $66.07 | Professional | 26 · Professional part | $26.92 | $30.20 | $66.07 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $89.13 Typical High $134.90 | Professional | TC · Technical part | $51.29 | $89.13 | $134.90 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $229.09 | Professional | None (both parts) | $70.79 | $70.79 | $229.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $83.18 Typical High $104.71 | Professional | 26 · Professional part | $32.36 | $83.18 | $104.71 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $69.18 Typical High $154.88 | Professional | TC · Technical part | $50.12 | $69.18 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $234.42 Typical High $489.78 | Facility | None | $81.28 | $234.42 | $489.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $72.44 Typical High $194.98 | Professional | None (both parts) | $44.67 | $72.44 | $194.98 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $24.55 Typical High $83.18 | Professional | 26 · Professional part | $17.78 | $24.55 | $83.18 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $21.38 Median $48.98 Typical High $141.25 | Professional | TC · Technical part | $21.38 | $48.98 | $141.25 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $154.88 | Facility | None | $117.49 | $117.49 | $154.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $102.33 Median $131.83 Typical High $154.88 | Professional | None (both parts) | $102.33 | $131.83 | $154.88 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $47.86 Median $70.79 Typical High $77.62 | Professional | 26 · Professional part | $47.86 | $70.79 | $77.62 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $75.86 Median $75.86 Typical High $131.83 | Professional | TC · Technical part | $75.86 | $75.86 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $58.88 Median $100.00 Typical High $204.17 | Professional | None (both parts) | $58.88 | $100.00 | $204.17 |
United Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $33.88 Typical High $70.79 | Professional | 26 · Professional part | $20.42 | $33.88 | $70.79 |
United Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $64.57 Typical High $144.54 | Professional | TC · Technical part | $34.67 | $64.57 | $144.54 |
7 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 $50.12 Median $58.88 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $23.44 | $25.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $66.07 Typical High $120.23 | Professional | 51 · Multiple procedures | $54.95 | $66.07 | $120.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.39 Median $26.30 Typical High $48.98 | Professional | 80 · Assistant surgeon | $22.39 | $26.30 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.49 Median $18.20 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $15.49 | $18.20 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.49 Median $18.20 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $15.49 | $18.20 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.49 Median $18.20 Typical High $33.88 | Professional | AS · PA/NP assist | $15.49 | $18.20 | $33.88 |
Where North Carolina sits
The same service costs 5.2 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
$117
AK $309AL $58.88
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.