How much rates vary
Facilitymedian $162 · 10th to 90th $162 to $182Professionalmedian $162 · 10th to 90th $123 to $316
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 $77.62 Median $79.43 Typical High $85.11 | Professional | 26 · Professional part | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | TC · Technical part | $77.62 | $81.28 | $85.11 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $87.10 Typical High $141.25 | Professional | 26 · Professional part | $87.10 | $87.10 | $141.25 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $89.13 Median $154.88 Typical High $257.04 | Professional | 26 · Professional part | $89.13 | $154.88 | $257.04 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $95.50 Typical High $251.19 | Professional | TC · Technical part | $37.15 | $95.50 | $251.19 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $81.28 Median $102.33 Typical High $218.78 | Professional | 26 · Professional part | $81.28 | $102.33 | $218.78 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $58.88 Typical High $234.42 | Professional | TC · Technical part | $29.51 | $58.88 | $234.42 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $81.28 Typical High $107.15 | Professional | 26 · Professional part | $75.86 | $81.28 | $107.15 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $42.66 Typical High $102.33 | Professional | TC · Technical part | $39.81 | $42.66 | $102.33 |
United Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $89.13 Typical High $199.53 | Professional | 26 · Professional part | $74.13 | $89.13 | $199.53 |
United Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $85.11 Typical High $194.98 | Professional | TC · Technical part | $38.02 | $85.11 | $194.98 |
15 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 $162.18 Median $162.18 Typical High $177.83 | Facility | None | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $162.18 Typical High $165.96 | Professional | None (both parts) | $151.36 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $31.62 | $32.36 | $32.36 |
Cigna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $165.96 Typical High $446.68 | Professional | None (both parts) | $123.03 | $165.96 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | None | $131.83 | $165.96 | $165.96 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Facility | None | $162.18 | $162.18 | $181.97 |
Medcost Setting Professional Modifier None (both parts) Typical Low $123.03 Median $125.89 Typical High $223.87 | Professional | None (both parts) | $123.03 | $125.89 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $63.10 Typical High $138.04 | Professional | 51 · Multiple procedures | $61.66 | $63.10 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $25.12 Typical High $54.95 | Professional | 80 · Assistant surgeon | $24.55 | $25.12 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $17.38 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $17.38 | $17.38 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $17.38 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $17.38 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $17.38 Typical High $38.90 | Professional | AS · PA/NP assist | $17.38 | $17.38 | $38.90 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $81.28 Median $162.18 Typical High $323.59 | Professional | None (both parts) | $81.28 | $162.18 | $323.59 |
United Setting Professional Modifier None (both parts) Typical Low $120.23 Median $169.82 Typical High $398.11 | Professional | None (both parts) | $120.23 | $169.82 | $398.11 |
Where North Carolina sits
The same service costs 3.9 times more in Alaska than in Texas. 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· 38th of 51
$162
AK $398TX $102
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.