How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $89.13 Median $95.50 Typical High $158.49 | Facility | None | $89.13 | $95.50 | $158.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None (both parts) | $89.13 | $89.13 | $97.72 |
BCBS North Carolina Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $131.83 | Facility | None | $91.20 | $91.20 | $131.83 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $154.88 Median $199.53 Typical High $302.00 | Professional | None (both parts) | $154.88 | $199.53 | $302.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $134.90 Typical High $245.47 | Professional | None (both parts) | $95.50 | $134.90 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Facility | None | $89.13 | $89.13 | $104.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $54.95 Median $109.65 Typical High $199.53 | Professional | None (both parts) | $54.95 | $109.65 | $199.53 |
United Setting Professional Modifier None (both parts) Typical Low $89.13 Median $120.23 Typical High $229.09 | Professional | None (both parts) | $89.13 | $120.23 | $229.09 |
9 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 $44.67 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $44.67 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $17.78 | $18.20 | $19.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $48.98 Typical High $83.18 | Professional | 26 · Professional part | $21.88 | $48.98 | $83.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $27.54 Median $61.66 Typical High $128.82 | Professional | 51 · Multiple procedures | $27.54 | $61.66 | $128.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.96 Median $25.12 Typical High $52.48 | Professional | 80 · Assistant surgeon | $10.96 | $25.12 | $52.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $17.38 Typical High $36.31 | Professional | 81 · Minimal assistant surgeon | $7.76 | $17.38 | $36.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $17.38 Typical High $36.31 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $17.38 | $36.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.76 Median $17.38 Typical High $36.31 | Professional | AS · PA/NP assist | $7.76 | $17.38 | $36.31 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $72.44 Typical High $125.89 | Professional | TC · Technical part | $33.11 | $72.44 | $125.89 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 7th of 51
$174
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.