How much rates vary
Facilitymedian $85 · 10th to 90th $85 to $85Professionalmedian $98 · 10th to 90th $69 to $275
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $77.62 Median $91.20 Typical High $104.71 | Professional | TC · Technical part | $77.62 | $91.20 | $104.71 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $69.18 Median $97.72 Typical High $316.23 | Professional | None (both parts) | $69.18 | $97.72 | $316.23 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $104.71 Typical High $213.80 | Professional | TC · Technical part | $104.71 | $104.71 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $131.83 Typical High $234.42 | Professional | None (both parts) | $79.43 | $131.83 | $234.42 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $97.72 Typical High $190.55 | Professional | TC · Technical part | $87.10 | $97.72 | $190.55 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | None | $109.65 | $138.04 | $138.04 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $85.11 | Facility | None | $83.18 | $83.18 | $85.11 |
Medcost Setting Professional Modifier None (both parts) Typical Low $66.07 Median $91.20 Typical High $120.23 | Professional | None (both parts) | $66.07 | $91.20 | $120.23 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $91.20 Typical High $107.15 | Professional | TC · Technical part | $47.86 | $91.20 | $107.15 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $70.79 Median $128.82 Typical High $162.18 | Professional | None (both parts) | $70.79 | $128.82 | $162.18 |
United Setting Professional Modifier None (both parts) Typical Low $79.43 Median $100.00 Typical High $208.93 | Professional | None (both parts) | $79.43 | $100.00 | $208.93 |
10 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 $41.69 Median $42.66 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $8.71 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $36.31 Typical High $50.12 | Professional | 26 · Professional part | $31.62 | $36.31 | $50.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $45.71 Typical High $81.28 | Professional | 51 · Multiple procedures | $33.11 | $45.71 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $18.20 Typical High $32.36 | Professional | 80 · Assistant surgeon | $13.18 | $18.20 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.12 Median $12.88 Typical High $22.91 | Professional | 81 · Minimal assistant surgeon | $9.12 | $12.88 | $22.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.12 Median $12.88 Typical High $22.91 | Professional | 82 · Assistant surgeon, no resident | $9.12 | $12.88 | $22.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.12 Median $12.88 Typical High $22.91 | Professional | AS · PA/NP assist | $9.12 | $12.88 | $22.91 |
Where North Carolina sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$97.72
AK $219FL $75.86
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.