How much rates vary
Facilitymedian $63 · 10th to 90th $63 to $63Professionalmedian $93 · 10th to 90th $62 to $174
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 Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $120.23 | Professional | None (both parts) | $63.10 | $63.10 | $120.23 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $18.20 Typical High $20.42 | Professional | 26 · Professional part | $17.78 | $18.20 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $44.67 Typical High $100.00 | Professional | TC · Technical part | $44.67 | $44.67 | $100.00 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $58.88 | $58.88 | $58.88 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None (both parts) | $199.53 | $199.53 | $204.17 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $30.20 Typical High $54.95 | Professional | 26 · Professional part | $17.38 | $30.20 | $54.95 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $46.77 Median $72.44 Typical High $288.40 | Professional | TC · Technical part | $46.77 | $72.44 | $288.40 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $102.33 Typical High $257.04 | Professional | None (both parts) | $79.43 | $102.33 | $257.04 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $22.91 Typical High $48.98 | Professional | 26 · Professional part | $17.78 | $22.91 | $48.98 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $81.28 Typical High $223.87 | Professional | TC · Technical part | $56.23 | $81.28 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | None | $102.33 | $141.25 | $141.25 |
Medcost Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
Medcost Setting Professional Modifier None (both parts) Typical Low $50.12 Median $89.13 Typical High $114.82 | Professional | None (both parts) | $50.12 | $89.13 | $114.82 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $18.62 Typical High $27.54 | Professional | 26 · Professional part | $17.38 | $18.62 | $27.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $95.50 Typical High $100.00 | Professional | TC · Technical part | $44.67 | $95.50 | $100.00 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $19.95 Median $69.18 Typical High $134.90 | Professional | None (both parts) | $19.95 | $69.18 | $134.90 |
United Setting Professional Modifier None (both parts) Typical Low $63.10 Median $100.00 Typical High $190.55 | Professional | None (both parts) | $63.10 | $100.00 | $190.55 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.60 Median $20.42 Typical High $45.71 | Professional | 26 · Professional part | $16.60 | $20.42 | $45.71 |
United Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $75.86 Typical High $151.36 | Professional | TC · Technical part | $45.71 | $75.86 | $151.36 |
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 $31.62 Median $31.62 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $14.13 | Professional | 53 · Discontinued | $12.59 | $12.59 | $14.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $57.54 Typical High $77.62 | Professional | 51 · Multiple procedures | $25.12 | $57.54 | $77.62 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.23 Median $22.91 Typical High $30.90 | Professional | 80 · Assistant surgeon | $10.23 | $22.91 | $30.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.08 Median $16.22 Typical High $21.38 | Professional | 81 · Minimal assistant surgeon | $7.08 | $16.22 | $21.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.08 Median $16.22 Typical High $21.38 | Professional | 82 · Assistant surgeon, no resident | $7.08 | $16.22 | $21.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.08 Median $16.22 Typical High $21.38 | Professional | AS · PA/NP assist | $7.08 | $16.22 | $21.38 |
Where North Carolina sits
The same service costs 3.2 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· 24th of 51
$91.20
AK $162TX $51.29
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.