How much rates vary
Facilitymedian $46 · 10th to 90th $37 to $49Professionalmedian $41 · 10th to 90th $29 to $51
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 $37.15 Median $45.71 Typical High $45.71 | Facility | None | $37.15 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $43.65 Typical High $46.77 | Professional | None (both parts) | $37.15 | $43.65 | $46.77 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $63.10 | $77.62 | $77.62 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $28.84 Median $41.69 Typical High $51.29 | Professional | None (both parts) | $28.84 | $41.69 | $51.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $23.99 Median $23.99 Typical High $83.18 | Professional | None (both parts) | $23.99 | $23.99 | $83.18 |
Medcost Setting Facility Modifier None Typical Low $34.67 Median $37.15 Typical High $48.98 | Facility | None | $34.67 | $37.15 | $48.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $39.81 Typical High $44.67 | Professional | None (both parts) | $33.88 | $39.81 | $44.67 |
United Setting Professional Modifier None (both parts) Typical Low $26.92 Median $36.31 Typical High $54.95 | Professional | None (both parts) | $26.92 | $36.31 | $54.95 |
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 $18.62 Median $20.42 Typical High $22.39 | Professional | 52 · Reduced service | $18.62 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.13 Typical High $9.12 | Professional | 53 · Discontinued | $7.41 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.17 Typical High $6.76 | Professional | 55 · Aftercare only | $5.62 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.07 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.72 | $4.07 | $4.57 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 26 · Professional part | $34.67 | $34.67 | $34.67 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.49 Median $16.98 Typical High $18.20 | Professional | 26 · Professional part | $13.49 | $16.98 | $18.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $16.98 Median $19.95 Typical High $22.39 | Professional | 51 · Multiple procedures | $16.98 | $19.95 | $22.39 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $6.76 Median $7.94 Typical High $8.91 | Professional | 80 · Assistant surgeon | $6.76 | $7.94 | $8.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.79 Median $5.62 Typical High $6.31 | Professional | 81 · Minimal assistant surgeon | $4.79 | $5.62 | $6.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.79 Median $5.62 Typical High $6.31 | Professional | 82 · Assistant surgeon, no resident | $4.79 | $5.62 | $6.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.79 Median $5.62 Typical High $6.31 | Professional | AS · PA/NP assist | $4.79 | $5.62 | $6.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $25.70 Typical High $26.92 | Professional | TC · Technical part | $20.42 | $25.70 | $26.92 |
Where North Carolina sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 34th of 51
$41.69
AK $100KY $34.67
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.