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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None (both parts) | $123.03 | $123.03 | $123.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $199.53 | Facility | None | $125.89 | $165.96 | $199.53 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $107.15 Median $117.49 Typical High $354.81 | Professional | None (both parts) | $107.15 | $117.49 | $354.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $125.89 Typical High $281.84 | Professional | None (both parts) | $120.23 | $125.89 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Facility | None | $123.03 | $123.03 | $141.25 |
Medcost Setting Professional Modifier None (both parts) Typical Low $97.72 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $97.72 | $162.18 | $162.18 |
United Setting Professional Modifier None (both parts) Typical Low $107.15 Median $128.82 Typical High $245.47 | Professional | None (both parts) | $107.15 | $128.82 | $245.47 |
11 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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $64.57 Typical High $64.57 | Professional | 26 · Professional part | $46.77 | $64.57 | $64.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $47.86 Median $79.43 Typical High $79.43 | Professional | 51 · Multiple procedures | $47.86 | $79.43 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $32.36 Typical High $32.36 | Professional | 80 · Assistant surgeon | $19.50 | $32.36 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $22.39 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $13.49 | $22.39 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $22.39 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $22.39 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.49 Median $22.39 Typical High $22.39 | Professional | AS · PA/NP assist | $13.49 | $22.39 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $70.79 Median $95.50 Typical High $95.50 | Professional | TC · Technical part | $70.79 | $95.50 | $95.50 |
Where North Carolina sits
The same service costs 2.8 times more in Alaska than in Indiana. 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
$123
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.