How much rates vary
Facilitymedian $37 · 10th to 90th $37 to $56Professionalmedian $37 · 10th to 90th $32 to $62
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier 26 · Professional part Typical Low $14.13 Median $14.13 Typical High $18.20 | Professional | 26 · Professional part | $14.13 | $14.13 | $18.20 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | TC · Technical part | $22.91 | $22.91 | $32.36 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $14.13 Median $29.51 Typical High $46.77 | Professional | 26 · Professional part | $14.13 | $29.51 | $46.77 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $25.70 Typical High $67.61 | Professional | TC · Technical part | $23.44 | $25.70 | $67.61 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $14.79 Median $16.60 Typical High $30.20 | Professional | 26 · Professional part | $14.79 | $16.60 | $30.20 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $21.38 Typical High $51.29 | Professional | TC · Technical part | $20.42 | $21.38 | $51.29 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $18.20 Typical High $21.38 | Professional | 26 · Professional part | $15.49 | $18.20 | $21.38 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $21.88 Median $22.39 Typical High $27.54 | Professional | TC · Technical part | $21.88 | $22.39 | $27.54 |
United Setting Professional Modifier 26 · Professional part Typical Low $12.88 Median $14.79 Typical High $28.18 | Professional | 26 · Professional part | $12.88 | $14.79 | $28.18 |
United Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $22.91 Typical High $44.67 | Professional | TC · Technical part | $18.62 | $22.91 | $44.67 |
18 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 $37.15 Typical High $56.23 | Facility | None | $37.15 | $37.15 | $56.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | None (both parts) | $37.15 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 52 · Reduced service | $18.62 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.76 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $30.90 Median $36.31 Typical High $52.48 | Professional | None (both parts) | $30.90 | $36.31 | $52.48 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 59 · Distinct service | $36.31 | $36.31 | $36.31 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | None (both parts) | $23.44 | $23.99 | $23.99 |
Cigna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $37.15 Typical High $81.28 | Professional | None (both parts) | $34.67 | $37.15 | $81.28 |
Medcost Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $74.13 | Professional | None | $47.86 | $47.86 | $74.13 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $46.77 | Facility | None | $37.15 | $37.15 | $46.77 |
Medcost Setting Professional Modifier None (both parts) Typical Low $33.88 Median $38.02 Typical High $52.48 | Professional | None (both parts) | $33.88 | $38.02 | $52.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $17.38 Median $19.50 Typical High $26.30 | Professional | 51 · Multiple procedures | $17.38 | $19.50 | $26.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.08 Median $7.76 Typical High $10.47 | Professional | 80 · Assistant surgeon | $7.08 | $7.76 | $10.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $4.90 Median $5.50 Typical High $7.41 | Professional | 81 · Minimal assistant surgeon | $4.90 | $5.50 | $7.41 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $4.90 Median $5.50 Typical High $7.41 | Professional | 82 · Assistant surgeon, no resident | $4.90 | $5.50 | $7.41 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $4.90 Median $5.50 Typical High $7.41 | Professional | AS · PA/NP assist | $4.90 | $5.50 | $7.41 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $16.22 Median $42.66 Typical High $85.11 | Professional | None (both parts) | $16.22 | $42.66 | $85.11 |
United Setting Professional Modifier None (both parts) Typical Low $32.36 Median $38.02 Typical High $72.44 | Professional | None (both parts) | $32.36 | $38.02 | $72.44 |
Where North Carolina sits
The same service costs 2.7 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· 46th of 51
$37.15
MN $83.18UT $30.90
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.