How much rates vary
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 $15.14 Median $15.14 Typical High $15.49 | Facility | None | $15.14 | $15.14 | $15.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $15.14 Median $15.49 Typical High $15.85 | Professional | None (both parts) | $15.14 | $15.49 | $15.85 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $12.30 Median $14.79 Typical High $17.78 | Professional | None (both parts) | $12.30 | $14.79 | $17.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10.23 Median $10.23 Typical High $28.84 | Professional | None (both parts) | $10.23 | $10.23 | $28.84 |
Medcost Setting Facility Modifier None Typical Low $14.79 Median $15.14 Typical High $17.78 | Facility | None | $14.79 | $15.14 | $17.78 |
Medcost Setting Professional Modifier None (both parts) Typical Low $12.02 Median $17.38 Typical High $18.20 | Professional | None (both parts) | $12.02 | $17.38 | $18.20 |
United Setting Professional Modifier None (both parts) Typical Low $10.23 Median $13.49 Typical High $19.95 | Professional | None (both parts) | $10.23 | $13.49 | $19.95 |
10 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 $7.59 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $7.59 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $3.02 | $3.09 | $3.09 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 26 · Professional part | $18.20 | $18.20 | $18.20 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5.89 Median $6.92 Typical High $7.24 | Professional | 26 · Professional part | $5.89 | $6.92 | $7.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $6.03 Median $8.71 Typical High $8.91 | Professional | 51 · Multiple procedures | $6.03 | $8.71 | $8.91 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.40 Median $3.47 Typical High $3.63 | Professional | 80 · Assistant surgeon | $2.40 | $3.47 | $3.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.70 Median $2.40 Typical High $2.51 | Professional | 81 · Minimal assistant surgeon | $1.70 | $2.40 | $2.51 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.70 Median $2.40 Typical High $2.51 | Professional | 82 · Assistant surgeon, no resident | $1.70 | $2.40 | $2.51 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.70 Median $2.40 Typical High $2.51 | Professional | AS · PA/NP assist | $1.70 | $2.40 | $2.51 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $8.91 Median $10.47 Typical High $10.72 | Professional | TC · Technical part | $8.91 | $10.47 | $10.72 |
Where North Carolina sits
The same service costs 2.7 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· 41st of 51
$14.79
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.