How much rates vary
Facilitymedian $195 · 10th to 90th $79 to $1,096Professionalmedian $245 · 10th to 90th $151 to $437
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 $194.98 Median $194.98 Typical High $234.42 | Facility | None | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $371.54 | Professional | None (both parts) | $194.98 | $194.98 | $371.54 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $83.18 Typical High $165.96 | Professional | 26 · Professional part | $70.79 | $83.18 | $165.96 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $125.89 Typical High $245.47 | Professional | TC · Technical part | $125.89 | $125.89 | $245.47 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $97.72 Median $125.89 Typical High $162.18 | Professional | 26 · Professional part | $97.72 | $125.89 | $162.18 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $131.83 Median $194.98 Typical High $275.42 | Professional | None (both parts) | $131.83 | $194.98 | $275.42 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 26 · Professional part | $181.97 | $181.97 | $181.97 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | TC · Technical part | $186.21 | $186.21 | $204.17 |
Cigna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $316.23 Typical High $602.56 | Professional | None (both parts) | $269.15 | $316.23 | $602.56 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $93.33 Median $112.20 Typical High $218.78 | Professional | 26 · Professional part | $93.33 | $112.20 | $218.78 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $173.78 Median $199.53 Typical High $389.05 | Professional | TC · Technical part | $173.78 | $199.53 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $1,071.52 | Facility | None | $194.98 | $281.84 | $1,071.52 |
Medcost Setting Professional Modifier None (both parts) Typical Low $208.93 Median $363.08 Typical High $426.58 | Professional | None (both parts) | $208.93 | $363.08 | $426.58 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $147.91 Typical High $165.96 | Professional | 26 · Professional part | $85.11 | $147.91 | $165.96 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $120.23 Median $269.15 Typical High $295.12 | Professional | TC · Technical part | $120.23 | $269.15 | $295.12 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None (both parts) Typical Low $245.47 Median $354.81 Typical High $691.83 | Professional | None (both parts) | $245.47 | $354.81 | $691.83 |
United Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $120.23 Typical High $204.17 | Professional | 26 · Professional part | $74.13 | $120.23 | $204.17 |
United Setting Professional Modifier TC · Technical part Typical Low $173.78 Median $245.47 Typical High $512.86 | Professional | TC · Technical part | $173.78 | $245.47 | $512.86 |
7 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 $97.72 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $41.69 | Professional | 53 · Discontinued | $38.90 | $38.90 | $41.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $213.80 Typical High $288.40 | Professional | 51 · Multiple procedures | $104.71 | $213.80 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $85.11 Typical High $114.82 | Professional | 80 · Assistant surgeon | $41.69 | $85.11 | $114.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $60.26 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $28.84 | $60.26 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $60.26 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $60.26 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $60.26 Typical High $81.28 | Professional | AS · PA/NP assist | $28.84 | $60.26 | $81.28 |
Where North Carolina sits
The same service costs 4.3 times more in Wisconsin than in Oregon. 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· 45th of 51
$245
WI $776OR $182
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.