How much rates vary
Facilitymedian $151 · 10th to 90th $79 to $1,096Professionalmedian $166 · 10th to 90th $107 to $282
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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None (both parts) Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None (both parts) | $107.15 | $107.15 | $177.83 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $51.29 Median $51.29 Typical High $95.50 | Professional | 26 · Professional part | $51.29 | $51.29 | $95.50 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $56.23 Typical High $97.72 | Professional | TC · Technical part | $56.23 | $56.23 | $97.72 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $74.13 Typical High $134.90 | Professional | 26 · Professional part | $74.13 | $74.13 | $134.90 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $102.33 Median $151.36 Typical High $223.87 | Professional | None (both parts) | $102.33 | $151.36 | $223.87 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 26 · Professional part | $144.54 | $144.54 | $144.54 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | TC · Technical part | $144.54 | $144.54 | $177.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $181.97 Typical High $363.08 | Professional | None (both parts) | $154.88 | $181.97 | $363.08 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $87.10 Typical High $173.78 | Professional | 26 · Professional part | $72.44 | $87.10 | $173.78 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $95.50 Typical High $190.55 | Professional | TC · Technical part | $81.28 | $95.50 | $190.55 |
Medcost Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $660.69 | Facility | None | $107.15 | $173.78 | $660.69 |
Medcost Setting Professional Modifier None (both parts) Typical Low $123.03 Median $208.93 Typical High $251.19 | Professional | None (both parts) | $123.03 | $208.93 | $251.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $61.66 Median $97.72 Typical High $120.23 | Professional | 26 · Professional part | $61.66 | $97.72 | $120.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $128.82 Typical High $134.90 | Professional | TC · Technical part | $52.48 | $128.82 | $134.90 |
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 $154.88 Median $229.09 Typical High $457.09 | Professional | None (both parts) | $154.88 | $229.09 | $457.09 |
United Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $91.20 Typical High $147.91 | Professional | 26 · Professional part | $54.95 | $91.20 | $147.91 |
United Setting Professional Modifier TC · Technical part Typical Low $102.33 Median $138.04 Typical High $302.00 | Professional | TC · Technical part | $102.33 | $138.04 | $302.00 |
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 $53.70 Median $53.70 Typical High $56.23 | Professional | 52 · Reduced service | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $21.38 | $22.39 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $102.33 Typical High $158.49 | Professional | 51 · Multiple procedures | $61.66 | $102.33 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $41.69 Typical High $63.10 | Professional | 80 · Assistant surgeon | $24.55 | $41.69 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $28.84 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $17.38 | $28.84 | $44.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $28.84 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $28.84 | $44.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $28.84 Typical High $44.67 | Professional | AS · PA/NP assist | $17.38 | $28.84 | $44.67 |
Where North Carolina sits
The same service costs 3.8 times more in Wisconsin than in Virginia. 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· 40th of 51
$166
WI $417VA $110
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.