How much rates vary
Facilitymedian $23 · 10th to 90th $23 to $107Professionalmedian $44 · 10th to 90th $23 to $145
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 26 · Professional part Typical Low $3.09 Median $3.16 Typical High $5.37 | Facility | 26 · Professional part | $3.09 | $3.16 | $5.37 |
Aetna Setting Facility Modifier TC · Technical part Typical Low $19.95 Median $20.42 Typical High $102.33 | Facility | TC · Technical part | $19.95 | $20.42 | $102.33 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $3.09 Median $3.09 Typical High $5.62 | Professional | 26 · Professional part | $3.09 | $3.09 | $5.62 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $19.95 Median $19.95 Typical High $43.65 | Professional | TC · Technical part | $19.95 | $19.95 | $43.65 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $2.63 Median $2.75 Typical High $5.75 | Professional | 26 · Professional part | $2.63 | $2.75 | $5.75 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $5.50 Median $8.71 Typical High $18.20 | Professional | 26 · Professional part | $5.50 | $8.71 | $18.20 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $102.33 Typical High $186.21 | Professional | TC · Technical part | $32.36 | $102.33 | $186.21 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $3.72 Median $4.57 Typical High $8.71 | Professional | 26 · Professional part | $3.72 | $4.57 | $8.71 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $91.20 Typical High $131.83 | Professional | TC · Technical part | $25.70 | $91.20 | $131.83 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $4.07 Median $5.62 Typical High $79.43 | Professional | 26 · Professional part | $4.07 | $5.62 | $79.43 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $37.15 Typical High $147.91 | Professional | TC · Technical part | $26.92 | $37.15 | $147.91 |
United Setting Professional Modifier 26 · Professional part Typical Low $3.16 Median $4.57 Typical High $8.32 | Professional | 26 · Professional part | $3.16 | $4.57 | $8.32 |
United Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $35.48 Typical High $128.82 | Professional | TC · Technical part | $20.42 | $35.48 | $128.82 |
17 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 Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $107.15 | Facility | None | $22.91 | $23.44 | $107.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $51.29 | Professional | None (both parts) | $22.91 | $22.91 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 52 · Reduced service | $11.48 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | 53 · Discontinued | $4.57 | $4.57 | $5.37 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $16.22 Median $33.11 Typical High $41.69 | Professional | None (both parts) | $16.22 | $33.11 | $41.69 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None (both parts) | $9.77 | $9.77 | $9.77 |
Cigna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $95.50 Typical High $138.04 | Professional | None (both parts) | $29.51 | $95.50 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $162.18 Typical High $169.82 | Professional | None | $47.86 | $162.18 | $169.82 |
Medcost Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $26.30 | Facility | None | $22.91 | $22.91 | $26.30 |
Medcost Setting Professional Modifier None (both parts) Typical Low $28.84 Median $43.65 Typical High $199.53 | Professional | None (both parts) | $28.84 | $43.65 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $20.42 Median $33.88 Typical High $100.00 | Professional | 51 · Multiple procedures | $20.42 | $33.88 | $100.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.13 Median $13.49 Typical High $39.81 | Professional | 80 · Assistant surgeon | $8.13 | $13.49 | $39.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $5.75 Median $9.33 Typical High $28.18 | Professional | 81 · Minimal assistant surgeon | $5.75 | $9.33 | $28.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $5.75 Median $9.33 Typical High $28.18 | Professional | 82 · Assistant surgeon, no resident | $5.75 | $9.33 | $28.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $5.75 Median $9.33 Typical High $28.18 | Professional | AS · PA/NP assist | $5.75 | $9.33 | $28.18 |
Oscar Health Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
United Setting Professional Modifier None (both parts) Typical Low $23.44 Median $41.69 Typical High $131.83 | Professional | None (both parts) | $23.44 | $41.69 | $131.83 |
Where North Carolina sits
The same service costs 2.9 times more in Kansas than in Maryland. 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· 20th of 51
$42.66
KS $74.13MD $25.70
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.