How much rates vary
Facilitymedian $45 · 10th to 90th $37 to $87Professionalmedian $56 · 10th to 90th $37 to $87
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 $10.23 Median $12.02 Typical High $23.44 | Facility | 26 · Professional part | $10.23 | $12.02 | $23.44 |
Aetna Setting Facility Modifier TC · Technical part Typical Low $27.54 Median $32.36 Typical High $66.07 | Facility | TC · Technical part | $27.54 | $32.36 | $66.07 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $10.23 Median $10.23 Typical High $16.60 | Professional | 26 · Professional part | $10.23 | $10.23 | $16.60 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $27.54 Typical High $54.95 | Professional | TC · Technical part | $27.54 | $27.54 | $54.95 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $14.79 Median $16.60 Typical High $18.20 | Professional | 26 · Professional part | $14.79 | $16.60 | $18.20 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | TC · Technical part | $56.23 | $60.26 | $60.26 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $21.88 Typical High $41.69 | Professional | 26 · Professional part | $10.00 | $21.88 | $41.69 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $64.57 Typical High $128.82 | Professional | TC · Technical part | $30.90 | $64.57 | $128.82 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $14.45 Median $16.60 Typical High $25.70 | Professional | 26 · Professional part | $14.45 | $16.60 | $25.70 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $39.81 Typical High $87.10 | Professional | TC · Technical part | $39.81 | $39.81 | $87.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $16.60 Typical High $20.89 | Professional | 26 · Professional part | $15.49 | $16.60 | $20.89 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $42.66 Typical High $51.29 | Professional | TC · Technical part | $31.62 | $42.66 | $51.29 |
United Setting Professional Modifier 26 · Professional part Typical Low $11.22 Median $13.49 Typical High $22.91 | Professional | 26 · Professional part | $11.22 | $13.49 | $22.91 |
United Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $43.65 Typical High $70.79 | Professional | TC · Technical part | $36.31 | $43.65 | $70.79 |
19 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 $37.15 Median $44.67 Typical High $87.10 | Facility | None | $37.15 | $44.67 | $87.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $70.79 | Professional | None (both parts) | $37.15 | $37.15 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.51 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $31.62 Median $37.15 Typical High $72.44 | Professional | None (both parts) | $31.62 | $37.15 | $72.44 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 59 · Distinct service | $37.15 | $37.15 | $40.74 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $38.02 Median $70.79 Typical High $588.84 | Professional | None (both parts) | $38.02 | $70.79 | $588.84 |
Cigna Setting Professional Modifier None (both parts) Typical Low $54.95 Median $56.23 Typical High $112.20 | Professional | None (both parts) | $54.95 | $56.23 | $112.20 |
Medcost Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | None | $74.13 | $74.13 | $85.11 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $48.98 | Facility | None | $37.15 | $37.15 | $48.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $52.48 Median $57.54 Typical High $87.10 | Professional | None (both parts) | $52.48 | $57.54 | $87.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $26.30 Median $28.84 Typical High $43.65 | Professional | 51 · Multiple procedures | $26.30 | $28.84 | $43.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.47 Median $11.48 Typical High $17.38 | Professional | 80 · Assistant surgeon | $10.47 | $11.48 | $17.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.41 Median $8.13 Typical High $12.30 | Professional | 81 · Minimal assistant surgeon | $7.41 | $8.13 | $12.30 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.41 Median $8.13 Typical High $12.30 | Professional | 82 · Assistant surgeon, no resident | $7.41 | $8.13 | $12.30 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.41 Median $8.13 Typical High $12.30 | Professional | AS · PA/NP assist | $7.41 | $8.13 | $12.30 |
Oscar Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $11.75 Median $44.67 Typical High $87.10 | Professional | None (both parts) | $11.75 | $44.67 | $87.10 |
United Setting Professional Modifier None (both parts) Typical Low $47.86 Median $57.54 Typical High $93.33 | Professional | None (both parts) | $47.86 | $57.54 | $93.33 |
Where North Carolina sits
The same service costs 3.3 times more in Minnesota 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· 29th of 51
$56.23
MN $105UT $31.62
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.