How much rates vary
Facilitymedian $59 · 10th to 90th $50 to $59Professionalmedian $22 · 10th to 90th $17 to $45
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 $52.48 Median $58.88 Typical High $60.26 | Facility | None | $52.48 | $58.88 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $27.54 | $58.88 | $58.88 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None (both parts) | $19.95 | $19.95 | $19.95 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $16.98 Median $21.88 Typical High $28.84 | Professional | None (both parts) | $16.98 | $21.88 | $28.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $28.18 Typical High $60.26 | Professional | None (both parts) | $19.95 | $28.18 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $58.88 Typical High $58.88 | Facility | None | $23.99 | $58.88 | $58.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $20.42 Median $21.38 Typical High $30.20 | Professional | None (both parts) | $20.42 | $21.38 | $30.20 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $14.45 Median $23.44 Typical High $33.88 | Professional | None (both parts) | $14.45 | $23.44 | $33.88 |
United Setting Professional Modifier None (both parts) Typical Low $22.39 Median $27.54 Typical High $58.88 | Professional | None (both parts) | $22.39 | $27.54 | $58.88 |
12 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 $13.80 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $13.80 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $5.62 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $4.17 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.82 | $5.89 | $5.89 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | 26 · Professional part | $9.12 | $9.12 | $12.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $30.20 Median $31.62 Typical High $45.71 | Professional | 50 · Both sides | $30.20 | $31.62 | $45.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $10.00 Median $10.72 Typical High $15.14 | Professional | 51 · Multiple procedures | $10.00 | $10.72 | $15.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $4.07 Median $4.27 Typical High $6.03 | Professional | 80 · Assistant surgeon | $4.07 | $4.27 | $6.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.82 Median $2.95 Typical High $4.27 | Professional | 81 · Minimal assistant surgeon | $2.82 | $2.95 | $4.27 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.82 Median $2.95 Typical High $4.27 | Professional | 82 · Assistant surgeon, no resident | $2.82 | $2.95 | $4.27 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.82 Median $2.95 Typical High $4.27 | Professional | AS · PA/NP assist | $2.82 | $2.95 | $4.27 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $13.80 Median $13.80 Typical High $18.20 | Professional | TC · Technical part | $13.80 | $13.80 | $18.20 |
Where North Carolina sits
The same service costs 2.8 times more in New York than in Georgia. 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· 48th of 51
$21.88
NY $52.48GA $18.62
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.