How much rates vary
Facilitymedian $162 · 10th to 90th $141 to $191Professionalmedian $275 · 10th to 90th $158 to $398
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 None Typical Low $141.25 Median $162.18 Typical High $190.55 | Facility | None | $141.25 | $162.18 | $190.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $134.90 Median $162.18 Typical High $199.53 | Professional | None (both parts) | $134.90 | $162.18 | $199.53 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $199.53 Median $234.42 Typical High $295.12 | Professional | None (both parts) | $199.53 | $234.42 | $295.12 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $204.17 Median $309.03 Typical High $407.38 | Professional | None (both parts) | $204.17 | $309.03 | $407.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $151.36 Median $204.17 Typical High $346.74 | Professional | None (both parts) | $151.36 | $204.17 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Facility | None | $190.55 | $190.55 | $199.53 |
Medcost Setting Professional Modifier None (both parts) Typical Low $109.65 Median $181.97 Typical High $295.12 | Professional | None (both parts) | $109.65 | $181.97 | $295.12 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $199.53 | Professional | None (both parts) | $131.83 | $131.83 | $199.53 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $177.83 Typical High $316.23 | Professional | None (both parts) | $141.25 | $177.83 | $316.23 |
12 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 $67.61 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $20.42 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $16.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $234.42 Typical High $295.12 | Professional | 25 · Same-day visit | $199.53 | $234.42 | $295.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $74.13 Typical High $117.49 | Professional | 26 · Professional part | $52.48 | $74.13 | $117.49 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $275.42 Typical High $489.78 | Professional | 50 · Both sides | $162.18 | $275.42 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $91.20 Typical High $165.96 | Professional | 51 · Multiple procedures | $54.95 | $91.20 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.88 Median $36.31 Typical High $66.07 | Professional | 80 · Assistant surgeon | $21.88 | $36.31 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $25.70 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $15.14 | $25.70 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $25.70 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $25.70 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $25.70 Typical High $45.71 | Professional | AS · PA/NP assist | $15.14 | $25.70 | $45.71 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $109.65 Typical High $158.49 | Professional | TC · Technical part | $79.43 | $109.65 | $158.49 |
Where North Carolina sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 2nd of 51
$275
AK $288AL $120
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.